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Medical Handbook 



FOR 



Missionaries in Cold Climates. 



BY 



' 



J. H. ROMIO, M. I): ■"> 



> " 3 * 3 > > ) > 



PHILADELPHIA. 

BOERICKE & TAFEL. 

1904. 






LIBRARY ^CONGRESS 
Two Conlfts Received 
APR 28 1904 
Copyright Entry 



CLASS ^ 



S *f ") » o 

COPY B 



XXc No. 



COPYRIGHT : 
J. H. ROMIG, M. D. 

1904. 



TO 
THE MEMORY OF 

MARGARET (RICKSECKBR) ROMIG 

THIS TREATISE IS 

AFFECTIONATELY DEDICATED 

BY HER SON, 

(REV.) J. H. ROMIG, M. D., 

MEDICAL MISSIONARY 

FOR THE 

MORAVIAN CHURCH 

IN 

ALASKA, U. S. A. 



PREFACE. 



The demand for medical literature is so well 
supplied that we would hesitate before offer- 
ing the public any contribution were it not 
that a peculiar need prompts the preparation 
of this small treatise. Missionaries laboring 
in foreign fields often find the texts prepared 
for the use of the general practitioner too 
lengthy and difficult of understanding, and are 
bewildered by the multitude of difficult words, 
when medical works are consulted. 

With a hope to supply a need, existing espe- 
cially in missions in Alaska, the treatise thus 
produced is intended for the use of mission- 
aries where medical attendants are not to be 
secured, because of the isolated locations of 
many missions. 

We are indebted to the following authors, 
whose works have furnished valuable sugges- 
tions in the preparation of this treatise : JDrs. 
Rotch, Johnson, Goodno, Osier, Dewey, 
Stevens, Van Harlingen, and especially to 
Dr. H. S. Weaver, for valuable assistance on 
the therapeutics of nose and throat affections. 

This treatise is submitted with a hope that 
the years of experience we have had in treat- 
ing the diseases prevalent in Alaska may make 
the work of service to those in such climates. 

J. H. ROMIG, M. D. 

Bethlehem, Pa., March, 1904. 



DOSE AND INDICATIONS FOR DRUGS. 

DOSE FOR A CHILD. 

"Young's rule :" Use the age of the child 
as the numerator of a fraction and the age of 
the child plus 12 as the denominator, reduce 
the fraction and you have the dose for a child. 

Example. 

-L _— — or - the dose of an adult. 

2 years + 12 14 7 

Children are much more susceptible to opi- 
ates than an adult and the dose of opiates 
should be only one-half as much as this rule 
indicates. Children require larger doses of 
cathartics than this rule indicates, usually dou- 
ble the amount of cathartics should be given. 
The Homoeopathic dosage cannot be given by 
this rule, but a little study will enable . any- 
one to so modify the dose as to get the best 
results. 

The mark indicates the tincture of the 
drug or strongest preparation. 

ix indicates 1 / w as much drug as is found in 
the 6. 

2x is 1 / 10 as strong as the ix. 

The larger the number in front of the x the 
weaker the preparation. 

The stronger preparations are best used for 
acute affections and the weaker preparations 



8 DOSE AND INDICATIONS FOR DRUGS. 

for chronic diseases, where the drug is given 
daily for a long period of time. 

Of the many symptoms given indicating a 
Homoeopathic drug there should be present at 
least three well defined symptoms before the 
drug is selected as a remedy. Do not think all 
the symptoms are necessary, but look for three 
or more prominent symptoms in selecting the 
remedy. 



ABSCESS. 

Abscesses are circumscribed areas filled with 
pus. There are two varieties, the acute and 
the cold, abscess. 

The symptoms of an acute abscess are pain, 
swelling, chill and fever. The acute abscess 
is filled with the ordinary pus germ. The loca- 
tion may be in any part of the body. An ab- 
scess works toward the surface of the body or 
in the line of least resistance, which is usually 
outward, but not always so. Deep abscesses of 
the neck or along the course of a muscle may 
burrow for some distance and rupture on the 
surface at a remote locality from the seat of 
a pus formation. An abscess always destroys 
tissue to a greater or less extent, and if allow- 
ed to take its own course will usually rupture 
spontaneously and discharge a thick, creamy 
pus and shreds of sloughed tissue. 

The treatment of an acute abscess is for the 
greater part surgical. 

When an abscess is expected to form, at 
times it may be dispelled by painting the part 
with Tr. Belladonna, and giving internally 
Ferrum phos. 2x, one tablet every 3 hours. 
Or giving Hepar sulphur 4X, one tablet three 
times a day. 

When the medical measures fail, which they 
will usually do, there remains but one thing to 



10 MKDICAL. HANDBOOK. 

be done, and that is to hasten the formation of 
pus and its liberation. Best accomplished by 
giving Hepar sulphur ix, one tablet every two 
or three hours. Applying warm poultices to 
the point where it is desired or expected that 
the abscess will break or be opened. Some 
drawing ointment as boil salve may be used 
to hasten the formation of a head or pointing 
spot in the abscess. When once the pus can 
be clearly located much pain and scarring may 
be prevented by lancing the abscess and thor- 
oughly cleansing the cavity. Carbuncle cavi- 
ties should be cleansed and cauterized. 

COLD ABSCESS. 

Glands and joints are often the seat of ab- 
scess formation of a tubercular or scrofulous 
nature. The real cause, however, is the pres- 
ence of the tubercle bacilli. Abscesses formed 
in this way and caused by this particular germ 
are slow in growth and attended with few- 
systematic disturbances. Pain, chill and fever 
are either absent or very mild. Because of the 
nature of the abscess and the few symptoms 
produced the name of cold abscess has been 
given. 

All cold abscesses are apt to rupture in 
time, and after rupturing the abscess cavity is 
apt to become infected with the ordinary pus 
germs, which, when they enter the cavity, set 
up all the symptoms, for the time, of acute in- 
fection or acute abscess. 



AMPUTATIONS. II 

The treatment of cold abscess is that of in- 
cision before the time of rupture, using the 
most rigid precaution to prevent infection. 
Drain the cavity of pus and sloughing tissue 
and pack with iodoform gauze to stimulate 
rapid granulation or healing of the cavity. 



AMPUTATIONS. 

The conditions calling for amputation are so 
varied that an exact rule cannot be given. 
Where from injury the circulation to any part 
has become injured to such an extent as to 
make the life of the part impossible, then 
amputation is at once the wisest thing. 

Where gangrene or blood poison threatens 
the life of the individual from poison from a 
given locality, and the poison cannot be re- 
moved, there remains but one thing to do, and 
that is to remove the poisoned extremity. 

After frost bites, if the bone has been frozen 
and amputation has become necessary, always 
go well above the line of demarkation for the 
point of severing the bone, for bones regain 
their vitality very poorly after a frost bite, and 
if the amputation is not performed well above 
the line of demarkation on the surface it will 
become necessary later to open the wound and 
remove more of the bone. 

Before operating always cleanse the seat of 



12 MEDICAI, HANDBOOK. 

the operation well and cover the part to be re- 
moved with a wet dressing of Bichloride of 
Mercury. See to it that no poison remains oh 
the surface that is to be operated upon, or that 
none be carried from other sources into the 
new wound. Bathe the part to be operated 
upon in Bichloride of Mercury solution and 
keep the part to be removed covered with an 
antiseptic dressing. Finally, the hands of the 
operator and his assistants must be thoroughly 
scrubbed and soaked in the i-iooo solution of 
Bichloride of Mercury. The instruments and 
thread must have been boiled for at least fifteen 
minutes to insure their carrying no germs that 
will poison the wound. The success of the 
operation depends on the detail of cleanliness 
observed and no one should be carel< 

AMPUTATION OF A FINGER OR TOE. 

All the preparatory steps having been taken, 
of cleanliness and of disinfection, tie firmly 
some cord or preferably a narrow bandage 
around the toe or finger back of the locality to 
be operated on, to control the circulation. Re- 
member the arteries of the fingers and toes are 
to the side and not above or below the finger. 
Bend ' the finger or toe at the joint to be 
severed. Cut across the back one-half inch in 
front of the flexed joint. Press the skin back 
and then cut through the joint. Follow the 
under surface of the bone for nearly an inch 
and then cut through to the palmar surface. 



IMPUTATIONS. 13 

Pick up and tie any spurting arteries. Loosen 
the cord or bandage that has been tied around 
the finger or toe. Scratch the end of the joint 
a little with the knife so that the joint surface 
may enter into the healing. Bring up the flap 
from below and sew it over the end of the joint 
to the tissues and skin above. It is desired 
that the flap of skin come from below as the 
palmar surface is less sensitive and affords a 
better cushion for the end of the bone and is 
better supplied with the nerves of touch than 
would be a dorsal flap. 

Cleanse and dress the wound when necessary. 

AMPUTATIONS AT THE HAND OR FOOT. 

The preliminary steps for the operation 
should be performed as for the removal of a 
toe or finger at the joint. A tourniquet may be 
used on the leg to control the bleeding or the 
spurting artery may be picked up with an 
artery clip as soon as divided. Begin the in- 
cision one-half inch back of the joint and cut 
on the back or dorsal surface to a point one 
inch below the joint. Encircle the finger or 
toe, cutting everything to the bone. Dissect 
back all the tissues to the joint and remove 
the bone at the joint. Scarify the end of the 
joint. Tie the spurting arteries. Bring the 
flaps together and sew, making the line of 
union up and down over the end of the bone. 
Dress and care for as occasion may demand. 



14 MKDICAL. HANDBOOK. 

AMPUTATIONS OF A LEG OR ARM. 

Amputations of a leg or arm can be done by 
anyone who will keep his head cool and re- 
member the following points : 

Before operating, see that the location to be 
operated upon has been cleansed and rendered 
thoroughly aseptic. 

Apply a rubber band tourniquet to the limb 
above the seat of operation. 

Remember that all the large arteries are to 
be found in the protected sides of the limbs. 

Make the flaps from both sides horizontal 
or vertical as will best cover the end of the 
bone, with a soft cushion of tissue. 

Cut the bone far enough back of the flesh to 
make no difficulty in covering the end of the 
bone. 

Tie all the bleeding arteries firmly. Then 
remove the tourniquet and tie any that may 
throb or spurt. 

Sew the flaps together evenly, but do not 
make the stitches too tight. 

Dress firmly and renew the dressing as oc- 
casion may demand. 

If the wound should open up, remove with 
very gentle traction any stitches that must 
come away. 

If bleeding should occur after the operation 
that firm pressure cannot control, it may be 
necessary to open up the wound and tie the 
artery that is bleeding. 



ASPHYXIA. 15 

If the wound should open during the time 
of healing, keep the edges of the flaps in as 
close proximity as possible by bands of ad- 
hesive plaster. 



ASPHYXIA AND ARTIFICIAL 
RESPIRATION. 

Artificial respiration or breathing is called 
for in drowning cases, for persons choking 
from ether, or accident where the breathing 
has ceased and the heart still beats. In 
drowning cases the heart may beat so feebly 
as not to be easily heard and yet recovery may 
follow diligent effort to resuscitate. 

If drowning has occurred, stand over the pa- 
tient and catch the arms around the body just 
below the ribs. Raise the body partially from 
the ground with the face down. Have some 
one open the mouth and draw down the ton- 
gue. When the water has run out of the lungs 
place the body on the back with the head 
lowered slightly. Have some one hold the 
lower jaw up and open as in giving ether. 
Then grasp the arms at the elbow and carry 
the arms outward and upward until they al- 
most meet over the head. Bring the arms 
down to the side and make firm pressure on 
the chest. Repeat the movements of the arms 
not more than eighteen times a minute. Most 
persons get in a hurry and work too fast. 



l6 MEDICAL HANDBOOK. 

Rub the legs and arms towards the heart. 
Dash hot or cold water on the chest. Slip a 
piece of ice into the rectum or forcibly dilate 
the rectum with the fingers or a dilator. 

The last two procedures are of especial 
value where there is a cessation from breath- 
ing, due to taking ether. 

Do not give up the efforts too soon. 

Give hypodermic injections of brandy or 
Strychnine as soon as the circulation can take 
it up, in drowning cases ; or at once, if there is 
any apparent circulation, as in asphyxia from 
ether. 



BURNS. 

Burns, Scalds and Superficial Frost 
Bites all demand about the same treatment. 
A burn may be only such as to redden the 
skin ; or more intense and cause blistering ; so 
severe as to destroy the superficial tissues. A 
simple reddening of two-thirds of the body is 
very apt to cause death. Blistering of one- 
third of the body is very serious and usually 
fatal. Deep burns of small areas may prov« 
fatal to children or the enfeebled. 

The scars of burns contract after healing 
and horrible distort inn may result. Infection 
of burned areas may occur and death result 
from blood poison. Waste matter that should 



BURNS. 17 

be eliminated by the skin may be forced upon 
the lungs, kidneys and intestines and cause 
serious complication to the recovery. 

Treatment. — For slight burns where there 
is reddening of the tissue or blistering,- noth- 
ing relieves the pain so much as a saturated 
solution of Baking Soda (as much Soda as 
the water will take up). Large blisters should 
be punctured with a needle, but do not remove 
the skin, as the air causes intense pain when it 
comes in contact with the exposed nerves. 
Superficial burns are the most painful and re- 
quire a dressing that w r ill exclude the air. 
Carbolized vaseline is a very good dressing 
spread on lint. 

Antiseptic dressings are to be used with cau- 
tion lest from so great a surface enough of 
the drug may be absorbed as to produce 
poisoning. Plain boiled water or Boric acid 
solution is to be preferred. Remove all sloughs 
and keep the dressings renewed lest blood- 
poison result from the absorption of pus. Keep 
the limbs extended or in a little more than the 
angle desired after healing, for there will 
likely be contraction that is very hard to over- 
come and had better be prevented. 



BRUISES. 

Bruises are injuries of the tissues beneath 
the skin. Usually produced by a fall or blow 
from some blunt instrument. There is more or 
less effusion of blood into the tissues, with 
heat, pain and swelling. If the injury is a 
deep one the discoloration w T ill be slow in 
reaching the surface, if shallow or in soft 
tissue, such as the eye, discoloration or ecchy- 
mosis soon follows. 

Treatment. — There has been an injury to 
the bloodvessels beneath the surface and bleed- 
ing is in progress. The object of first import is 
to stop the bleeding, which is best accom- 
plished by firm bandaging, by cold compresses 
or very hot applications, and by astringent 
lotions, such as Leadwater and Laudanum. 
Later there is much benefit derived from the 
use of soothing lotions, of which Tr. Arnica 
and water in equal parts is the most frequently 
employed. Arnica should not be used if the 
skin has been broken, as it has been known to 
cause erysipelas when used on open surfaces. 
The Fluid Extract of Hamamelis is to be pre- 
ferred where the skin has been injured. Ap- 
ply the Arnica or Hamamelis with gentle fric- 
tion or on wet compresses. 

When once the bleeding has ceased and ab- 
sorption has begun hot applications and gentle 



BOIXS. 19 

massage or rubbing will aid much 111 dispelling 
the blood from the tissues and hastening the 
disappearance of the color, which is often the 
most urgent part of the treatment. 



BOILS. 

Boils are caused by microbic infection of the 
deeper structures, resulting in one or many 
circumscribed painful areas or localized spots 
of inflammation. The microbe travels down 
the canal of a hair or through the opening of a 
sweat gland and first produces a circumscribed, 
painful area, later a small pustule and finally 
enters the deeper structures of the skin and 
connective tissue. As a result of the inflam- 
mation a central core perishes and is sloughed 
away. 

A boil may be of the blind variety, where 
there is only pain and swelling, but true pus 
formation does not occur. The common form of 
boils goes on to the formation of pus, and 
opens with the discharge of pus and the 
sloughing aw r ay of a central core. A boil runs 
its course in a week or ten days. There may 
be successive crops of boils, but each one is 
independent of the other. Unhealthy condi- 
tions of the skin and impurities of the blood, 
as well as the change of seasons and over- 
work or exhaustion, all predispose to the 
formation of boils. The neck and back, the 



20 MEDICAI, HANDBOOK. 

face and margins of the scalp and ears, and 
the axilla and groin and perineum are all 
favorite localities for the development of boils. 
Treatment. — When there is simply pain 
and swelling a threatened boil may be pre- 
vented by pulling out the hair in the centre of 
the inflamed area and painting the part first 
with a very strong solution of Carbolic acid, 
and later with the Fl. Ext. of Belladonna. 
When once an abscess has formed hot applica- 
tions, such as poultices, will hasten the head- 
ing or opening of the boil. Boil salve may be 
applied to soften the tissues and draw or 
hasten the heading of the abscess. Incision and 
drainage would be the ideal measures, but 
most persons prefer to allow the boil to open 
and discharge, after which rapid healing 
follows. 



BLOOD SPITTING. 

The causes of blood spitting may be direct 
injury to the mouth, throat or lungs. Inflam- 
matory affections of the respiratory system. 
Obstruction to the venous circulation, as is 
common in heart and liver diseases. In scurvy, 
in consumption of the lungs, where the de- 
structive process causes some artery-wall to 
break down, and in kidney diseases, where the 
general blood pressure is raised to such an ex- 



BLOOD-SPITTING. 21 

tent that the arteries of the lungs may rupture 
from high arterial tension. 

Symptoms. — Usually a slight cough, a warm 
sensation beneath the breast bone, followed by 
a warm, salty fluid in the mouth. Sometimes 
the presence of the blood in the mouth is the 
first symptom the patient has. The blood is 
generally raised by coughing and is bright red 
and frothy, and is intimately mixed with air 
and mucus. Associated with this may be heard 
rales or a bubbling in the region of the chest 
from which the blood comes. Blood from the 
stomach is always dark in color and is clotted 
and not mixed with air and mucus, but is 
mixed with food. 

Treatment. — Absolute rest of mind and 
body is necessary. For adults give a teaspoon- 
ful dose of a strong salt solution, often re- 
peated, and have the patient rest in bed, or 
give 10 to 15 drops of the Tr. of Arnica, or 
Y^ to 1 teaspoonful of the Fluid Extract of 
Hamamelis, every 20 to 30 minutes, until the 
blood spitting is better. For adults who are 
well and strong: 

J^. Morphine sulphate %. gr. 

Atropine sulphate, V100 gr ' 

If the patient is weak give about one-half of 
this dose and repeat in three or four hours, if 
necessary. 



NORMAL BREATHING. 

The normal breathing of infants is about 
thirty-five per minute for the first year, 
twenty-five for the second year, about twenty 
at the fourteenth year, and eighteen per 
minute for adult respiration. Age, sex, ex- 
citement, work, and disease all modify the 
number of respirations per minute. Febrile 
and nervous disorders tend to increase the 
number of breaths in the minute. In fainting 
and brain injuries and depressed nervous con- 
ditions the respiration is slowed. 



BED-WETTING OR ENURESIS. 

Bed- wetting is more a symptom than a dis- 
ease. There is always the nervous condition 
of the patient to be taken into consideration. 
The mechanism of micturition is a complicat- 
ed one, and only under the control of the will 
after the child has reached an age and period 
where the inhibitory centers hold in abeyance 
the reflex nerve action. Punishing a child for 
bed-wetting or for the involuntary discharge 
of urine is, as a rule, cruel and ignorant prac- 
tice. The reflex nerve fibers governing the 
muscular walls of the neck of the bladder 



ENURESIS. 23 

respond to the irritation caused by distension 
of the bladder. The reflex irritation travels 
up to the inhibitory centers in the back where 
the impulse to relax the sphincter of the blad- 
der and expel the contents is stimulated. In 
early childhood the emptying of the bladder 
is accomplished by the reflex and inhibitory 
nerves and the act requires little or no work 
on the part of the will. 

About the second year in life the will is 
brought into play and the child assumes con- 
trol of the function. Some children may be 
subject to periodical attacks of enuresis. 
Some are troubled only at night when the 
sleep is so sound that they lose control of the 
mechanism of the bladder. 

Hyperacidity of the urine or anything that 
will irritate the bladder may cause bed-wet- 
ting. Pin-worms either of the rectum or 
after traveling into the genital tract, as is 
often the case with girls, may, by their irri- 
tant action in the rectum or genitals, cause 
irritability of the bladder and involuntary 
urination. 

A tight and adherent prepuce may excite 
the reflex nerves so as to be the cause of 
enuresis. When this is the case circumcision 
will very likely relieve the nervous irritation 
and cure the enuresis. Remember that, dur- 
ing childhood, there is a lack of development 
of the inhibitory centers, and that the will 
has not the control of the bladder as is re- 



24 MEDICAI, HANDBOOK. 

quired in after life. We hope, if nothing 
more, to ask mothers to remember the child 
is undeveloped and punishing is a cruelty in 
many instances. 

Treatment. — There is little use to give 
drugs when the cause is to be found in the 
rectum or genital tract. If pin-worms exist 
treat that cause. If the genital tract is ex- 
coriated, or there is phymosis, relieve the ir- 
ritating cause. Bathing the back with cold 
water at bed-time is sometimes beneficial. 
Quite hot water may be used in place of cold 
water. Simple friction or massage of the 
back just above the hips may be employed 
where no water is used. Elevating the foot 
of the bed a little may do some good. 

Internally give Belladonna ix, i tablet 
morning and evening. 

Cimicifuga ix, tablet three times a day may 
be tried. 

Do not give much liquid for supper. Try to 
remove any local irritation and have patience 
and all cases will recover. Some even do not 
obtain full control of the urinary apparatus 
until ten or twelve years of age. Children 
otherwise healthy may be thus troubled much 
to their own chagrin and taunts are cruel. 



BLOOD-POISON. 

Blood-poisoning is due to the absorption of 
the products of infected areas. The putrefac- 
tive germs may enter the circulation or the 
poison of these germs may produce changes in 
the blood that are very serious and often fatal. 
Abscesses. Injuries resulting in infection and 
child-bed infection are the most frequent 
causes of blood-poison. 

The symptoms of blood-poison are a con- 
tinued high fever ; headache ; weak, rapid 
pulse ; nausea or want of appetite ; slight 
jaundice; diarrhoea as the poison becomes 
more intense, and finally a typhoid, dull, list- 
less appearance marks the coming fatality. A 
cold, clammy sweat may also be present in the 
later stages of blood-poison. In some cases, 
particularly where the infection is in the ab- 
domen, the temperature may be subnormal as 
the end is approached. 

Treatment. — Where there is an area that is 
continually giving off poison and charging the 
system with something the blood cannot resist, 
the only thing to do is to remove the source of 
infection. If gangrene is the cause, remove 
the part. If an abscess, empty the pus cavity, 
and thoroughly cleanse the part. If a womb, 
as in child-bed fever, the uterus should be 
washed out with an antiseptic solution. This 



26 MEDICAI, HANDBOOK. 

not every one can do, but anyone can give 
a hot antiseptic vaginal injection and elevate 
the patient's head and try to get better drain- 
age of the womb. Try, from whatever source 
the infection comes, to remove the cause; this 
may require an amputation, be that as it may, 
remove the cause. 

'Internally give stimulants. Quinine, five 
grains every four hours, acts well on the stom- 
ach and in the blood. Alcoholic stimulation 
should be resorted to, and it is wonderful how 
much alcoholic stimulation can be borne by 
one suffering with blood-poison. Quinine and 
whiskey are almost indispensable remedies in 
blood-poison. Strychnine, 1 / part of a grain, 
may be given every three to six hours. Try to 
keep up the heart. 

The food should be light, but nourishing. 
Eggnogs, beef-tea and similar liquid foods are 
of much value. 



COLD IN THE HEAD, CORYZA. 

A cold in the head is an acute inflammation 
of the upper air passages. Exposure is the 
chief cause. At the onset the patient is lan- 
guid and chilly. The nose may seem dry and 
breathing difficult. Soon there is a watery 
discharge from the nose and the nostril feels 
raw and sore. The mucous membrane of the 



COI,D IN THE HEAD. 27 

eyes may share in the inflammation and the 
eyes water. The throat may become involved 
and painful, and the voice husky or lost. Taste 
and smell may be absent. Usually in a few 
days the symptoms subside and recovery fol- 
lows. 

Treatment. — In the early stage where 
there is chill and fever with rapid pulse give 
Aconite ix, one tablet every hour. When the 
eyes begin to water and the nose runs and the 
urine becomes free and almost colorless, as is 
often the case, and the patient feels drowsy, 
languid and sore all over the body, give Gel- 
semium 0, one tablet every hour, until the pro- 
fuse running of the nose ceases. Later for the 
cold in the head, where the discharge is bland, 
Pulsatilla 0, one tablet every two hours, is 
often very beneficial. At the onset of a cold in 
the head, or cold on the chest, a prompt purge 
will assist greatly other methods of treatment. 
The old mother's remedy of fried onions for 
supper is by no means inefficient, and for those 
who like onions not unpleasant treatment. 



BRONCHITIS. OR COLD ON THE CHEST. 

The symptoms of acute cold on the chest 
may mark the onset of measles, whooping 
cough or la grippe. Irritant vapors may 
also cause the symptoms of a cold on the 
chest. The usual cause is exp jsure to cold 
or damp atmosphere, after the body has been 
over-heated. The skin is very active in 
eliminating waste material from the body. 
When all the pores of the skin are open and 
perspiration is present, a sudden change of 
the temperature or a draught may cause the 
pores to close and temporarily cease to act. 
The waste matter that should have been 
thrown off by the skin is forced back on the 
lungs, bowels and kidneys. As a result from 
over-work and congestion a cold on the chest 
may ensue with cough and expectoration. 
The bowels may be irritated and congested 
and a diarrhoea result, or the kidneys may 
suffer in like manner and be forced to do extra 
work. 

Treatment. — When from exposure a cold 
on the chest is developed, much good may be 
accomplished by relieving the lungs of some of 
the strain by asking more of the bowels, for 
which purpose a prompt purge should be 
given. Soaking the feet in hot water will 
often help to relieve the congestion of the 



BRONCHITIS. 29 

chest, as it does the head in headache, by 
drawing some of the blood elsewhere. 

Chill, fever and rapid pulse are to be ex- 
pected in the early stage, and call for Aconite 
0, 1 tablet every hour for five or six doses. 
When cough and rattling of the chest from 
mucus begins to develop, or following the 
Aconite, one of the best remedies is Ipecac y 
1 tablet every hour until the expectoration is 
free. Ipecac, besides stimulating the lungs, 
causes the skin to do more work and aids in 
restoring the equilibrium of the excretory 
functions. The various cough medicines given 
to hasten expectoration and quiet the irrita- 
bility of the mucous membranes of the bron- 
chial tubes are very good, but care should be 
observed in giving cough syrup to children 
because many contain opiates that are poorly 
borne by children. 

For an irritating cough at night that pre- 
vents sleep wring out a cloth in quite hot 
water and place on the chest next to the skin. 
Bathing in hot water and brisk rubbing with 
a coarse towel will help to start the skin to 
action. Avoid a chill or exposure to draught 
during the bath. 



CHRONIC COUGH OR CHRONIC 
BRONCHITIS. 

The causes of chronic cough may be repeat- 
ed colds or repeated attacks of acute bron- 
chitis. Chronic heart, lung and kidney dis- 
eases are often the cause of chronic cough. 
Old people are apt to have a chronic cough. 

The symptoms are shortness of breath on 
exertion, and soreness behind the breast bone, 
associated with chronic cough and expectora- 
tion. 

Treatment. — If due to any chronic lesion 
of the heart, or kidneys, or lungs. Treat the 
cause. Improve the general health. Avoid 
exposure. Give any good expectorant cough 
medicine. 



CARBUNCLE. 

Carbuncles differ from boils in being deep- 
er seated, longer in duration and more dan- 
gerous and destructive in nature. The cause 
of carbuncles is much the same as that of 
boils, however certain diseases such as 
B right's disease, predispose to carbuncles. 
The favored locality for the formation of a 
carbuncle is on the back of the neck, or on 
the back and on the buttox. When a car- 
buncle forms there is much disturbance of 



CARBUNCLE. 31 

the system, resembling that of acute abscess. 
There is chill, fever and burning pain. At 
first there is a darkened, painful area, not 
localized as in the case of a boil, but flattened 
and extensive ; the skin is hot and has a 
dough-like feel. In about two weeks the car- 
buncle begins to head and several points be- 
come white and finally break down, discharg- 
ing at first a watery pus ; later there may be 
seen in each of the openings white shreds 
and masses of tissue that are sloughing away, 
and finally all the openings will coalesce and 
one large sloughing cavity be formed. When 
all is done and the cavity free of sloughs heal- 
ing takes place rapidly. A carbuncle lasts 
from four to six weeks and is a very serious 
disease when attacking the very young or 
very old, or those reduced in health by dis- 
ease. 

Treatment. — The early free incision and 
opening the cavity to its extent, and thorough 
cauterizing with caustic or pure Carbolic acid, 
is the best and safest procedure. Poultices 
do more harm than good. To allow a car- 
buncle to form and open is at times a great 
risk, particularly in the enfeebled, as blood- 
poison may easily result from so large a pus 
cavity. 

Those suffering from a carbuncle should 
have the best of nourishing food and be given 
Quinine 3 grains three times a day after 
meals. Or Tr. Nux vomica 3 drops three 



32 MKDICAI, HANDBOOK. 

times a day after meals, and at times alco- 
holic stimulants. Keep up the strength of 
the patient if possible. There are two reme- 
dies that are of value for either carbuncles 
or boils : 

Ferrum phos. ix strength, i tablet every 
four hours, or Hepar sulphur 4X, i tablet 
every three hours. Either of the foregoing 
may be used where inflammation' is present 
and a boil or a carbuncle is threatened, with 
a hope to avert pus formation. When once 
pus forms and it is desired to hasten the 
heading of a boil or carbuncle given Hepar 
sulphur ix, 2 tablets every three hours. 



CONVULSIONS. 

Convulsions may be of several varieties : 
Epilepsy, puerperal or child-bed convulsions, 
and infantile convulsions. 

The cause of convulsions may be in the 
brain, as is shown in epilepsy, or excited by 
nervous stimuli from any part of the system, 
as is shown by the convulsions common to 
children. 

Convulsions originating in the brain, from 
tumor or lesion of the brain, are apt to be 
only partial, attacking first a hand or one side 
of the body, and finally becoming general, 
though the movements may only be seen on 
the affected side. 



CONVULSIONS. 33 

Convulsions caused by irritation from with- 
out or reflex nervous irritation are of both 
sides of the body during the convulsion, and 
after the convulsion one side is not more af- 
fected than the other, as is apt to be the case 
where the lesion is in the brain structures. 
Convulsions of childhood are apt to result 
from indigestion, teething, worms in the in- 
testines, and precede the onset of the erup- 
tive fevers, meningitis, measles, whooping 
cough, etc. 

If the pulse is rapid and the temperature 
high and the head congested, as is shown by 
the throbbing fontanelle, the convulsion may 
precede some of the eruptive fevers. If the 
temperature is normal and the pulse not much 
accelerated, the cause may be something in 
the nose or ear. Sometimes convulsions re- 
sult from an exhausted condition, such as the 
loss of blood or continued diarrhoea. The on- 
set of a convulsion is usually preceded by a 
period of uneasiness. Then there is rigidity 
and a choking noise, the eyes roll up, the 
lips are blue and the hand clenched. Twitch- 
ing of the arms and feet, foaming at the 
mouth, rigidity of the body and possibly invol- 
untary urination are present during a convul- 
sive spasm. Then follows relaxation and sleep. 

Treatment. — There is little to be done for 
epileptic convulsions except to put something 
between the teeth that the tongue be not 
bitten. 



34 MEDICAI, HANDBOOK. 

Child-bed convulsions are very difficult to 
treat. Give 5 drops of the Tr. Veratrum 
viride every fifteen minutes until the pulse is 
reduced to about sixty per minute, not below 
sixty per minute. Bromide of Potash may be 
given in thirty-grain doses, with fifteen grains 
of Chloral hydrate; give per rectum as an 
injection in 1 ounce of water; repeat in a 
half hour, if necessary. Ether is of much ser- 
vice and should not be forgotten. Give enough 
to quiet the patient. If Chloral has not been 
given, give Chloroform until the nervous ex- 
citability has lessened. 

Infantile convulsions should receive the 
most consideration, as they are the most fre- 
quent encountered. The first thing usually 
done is to put the child in a warm bath (ioo° 
F.), which relieves the nervous excitement to 
a marked degree. Ether may be given until 
the convulsions cease. Bromide of Potash 
may be given before the convulsion begins, 
from 5 to 10 grains in water for two or three 
doses, about thirty minutes apart. The drug 
may be given per rectum if the child is in 
convulsions, 10 grains to y 2 ounce of water. 

If the convulsion is due to a foreign body 
in the nose or ear, or to exhaustion from loss 
of blood or diarrhoea, the hot bath is not ad- 
visable. Remove the foreign body. If from 
exhaustion give brandy and water, 1 to 2 tea- 
spoonfuls to the same amount of water, as 
an injection. If teething is the cause lance 



CONSTIPATION. 35 

the offending gum. If the stomach, empty 
the stomach and given an enema, and later a 
cathartic. Try to remove the cause and to 
prevent a recurrence. 



CONSTIPATION. 

Causes. — More cases are traceable to a want 
of regularity of habit than to any other cause. 
Torpidity of the liver and inactivity of the 
bowels, sedentary habits or want of proper 
physical exercise play an important role as 
causative factors. Dark complected people are 
more often constipated than fair ones. Preg- 
nancy, tumors, stricture of the bowel, old 
age and drug habits are all causative factors. 

Symptoms of constipation are headache, 
loss of appetite, furred tongue, the absence 
of an evacuation for several days. Nausea or 
vomiting and diarrhcea following an interval 
of constipation should lead one to suspect im- 
paction and should be treated accordingly. 
Piles, ulcers of the rectum and pelvic distress 
are all caused or encouraged by constipation. 

Treatment. — Attend regularly to the call 
of nature at a set hour of the day and allow 
nothing to postpone this obligation. If this 
one vow is faithfully kept it is better than 
many drugs in the treatment of the trouble. A 
cup of cold water before retiring and one soon 
after rising are of much service. Fruits, such 
as prunes and figs, or fruits in general, are of 



36 MEDICAI, HANDBOOK. 

much benefit to the habitually constipated, es- 
pecially so if made part of the regular diet. 
The coarser muscles and foods all have a lax- 
ative action on the bowel. If the abdomen is 
flabby a fifteen minutes' massage and the 
wearing of an abdominal support will be of 
much service, especially so in the case of the 
aged. 

A glycerine suppository or a simple enema 
at a regular hour is to be recommended to es- 
tablish a regular habit, but not continued when 
the habit is formed. All of the many cathartics 
will give relief for the time, but few, if any, 
there are that do not constipate the more 
firmly when their action ceases, leaving the 
patient in a worse state than before. The 
continued use of drugs aggravates a consti- 
pated habit and their use is only a method of 
temporizing and the confession of laziness on 
the part of the habitually constipated. The 
constipation of pregnancy should be relieved 
by enema, of the aged by enema and massage 
and the abdominal support ; that from torpor 
of the liver or atony of the bowel, by taking 
more regular exercise, the use of coarse mush 
for breakfast, and to start up the liver : 

IJ. Calomel 1 / lo grain. 

Soda Bicarb., ...i grain. 

Pill. 

Take i pill every three hours for a day or 
two. 

Where there is impaction of the bowel it 



croup. 37 

may be necessary to use the finger or the 
small end of a spoon to remove a portion of 
the hardened mass ; but, if possible, induce 
the bowels to move by giving slowly an 
enema of soap water ; do not stop until the 
bowel is thoroughly empty. 

CONSTIPATION IN INFANTS. 

Constipation in infants is common, and 
often the cause is hard to ascertain. It is 
thought by some to be due to a lack of fat 
in the food, and the supply of this in the form 
of olive oil or any good fat is often suffi- 
cient to relieve the trouble. Small supposi- 
tories of cocoa butter or soap suppositories 
are very effective to bring about a movement. 
Soap water enemas are also very successful. 

To move the bowels : 

IJ, . Olive oil, Yz drachm. 

Castor oil, Y* drachm. 

Mix well and give one dose. Repeat this 
every six hours until a movement is produced. 

Cream may be added to the milk of bottle- 
fed babies, or olive oil may be given with the 
food of infants, which alone may be enough to 
relieve the constipation. 



CROUP. 

Exposure to cold and damp and acute ca- 
tarrhal conditions of the larynx may cause a 
train of symptoms known as croup. 



38 MEDICAI, HANDBOOK. 

Symptoms. — The symptoms of croup are 
high temperature, hoarseness of the voice, and 
a metallic cough, following exposure to cold 
and damp; this may continue for a few days 
and then pass off without more marked symp- 
toms. The child may have been playing about 
all day and have no more symptoms than a 
slight cough. In the night, after a restless 
period of sleep, the child suddenly springs up 
in the bed and with a wild, frightened ap- 
pearance clutches at its throat. The voice, 
which was only hoarse during the day, is 
now loud and harsh, the cough has a decided 
metallic ring, which, when once heard, can 
always be recognized in succeeding cases. The 
nostrils are dilated. There is much effort in 
breathing and the chest walls may be seen 
heaving up and down as the child struggles 
for breath. The face may be congested and 
even bluish, the skin hot and the pulse tense 
and rapid ; suffocation may seem near at hand. 
The attack usually passes off in an hour or 
two, and the child seems as well as usual the 
following day. Usually an attack occurs on 
the following night and is more severe than 
the first. One attack predisposes to subse- 
quent attacks throughout childhood. 

Treatment. — From the time the child 
shows hoarseness and a tendency to the 
metallic ringing cough, which is a character- 
istic of croup, he should be confined to the 
house, in a warm room, where the atmosphere 



DIPHTHERIA. 39 

is kept damp by steam. Give Wine of Ipecac, 
4 drops at noon, again at 3 o'clock and again 
at bed time. Should an attack of the croup 
occur, give from 10 to 20 drops of the Wine 
or Syrup of Ipecac, and, if necessary, give 
even enough to cause vomiting, which will 
usually dislodge the mucus from the throat 
and give prompt relief. In addition to this, 
place the child in an atmosphere of steam, the 
temperature of the room being raised to 75 
degrees F. Moist heat to the throat or hot 
baths are also beneficial. 

The succeeding treatment is to keep the 
child in a warm room and give Ipecac in 
small doses in the afternoon and evening for 
a few days until all the symptoms disappear. 



DIPHTHERIA. 

Diphtheria is an acute contagious disease, 
caused by a bacillus which attacks the mem- 
brane of the throat. 

The disease is more common during early 
childhood than in later years, though no one 
is immune. Diphtheria may be severe or mild ; 
but if mild in one case it may be severe in 
another. Pharyngitis or sore throat predis- 
poses to diphtheria. There is a period of in- 
cubation from two to ten days after exposure. 
Diphtheria usually begins with chills, fever, 
languor and sore throat. The child complains 
of pain on swallowing. The muscles of the 



40 MEDICAL HANDBOOK. 

neck are stiff. The glands under the jaw are 
swollen and tender. The pulse is rapid and 
weak. The fever is not regular and never 
very high. There is a grayish-white mem- 
brane found on the tonsils that extends around 
the sides of the throat and up over the sides of 
the soft palate. The posterior wall of the 
throat may have patches or be covered with 
the same membrane. The membrane of diph- 
theria, when stripped off, leaves a raw and 
bleeding surface. Which surface is soon cov- 
ered again with the same kind of membrane. 

The membrane of diphtheria may extend 
into the larynx or indeed may begin there and 
form what is commonly called membraneous 
croup. 

The symptoms of diphtheria of the larynx 
or membraneous croup are the same as given 
for diphtheria, with the addition of hoarse- 
ness, croupy cough and difficult breathing. 

Diphtheria lasts from a few days to two 
weeks. 

The danger from diphtheria seems to be 
from the amount of poison secreted by the 
germs and absorbed by the blood. 

Following diphtheria there may be para- 
lysis of the throat and swallowing becomes 
very difficult for a long time. Drooping of 
the eyelids, or squints, or cross-eye may re- 
sult from the disease. Rarely the extremities 
are paralyzed. 

Treatment. — One suffering from diphtheria 



DIPHTHERIA. 41 

should be isolated that others may not be in- 
fected. Keep the patient quiet. Give good 
nourishing food. Liquid food will be prefer- 
able, such as eggs, milk, beef tea and gruels. 
Whisky or brandy should be added to the 
food as soon as the pulse weakens or becomes 
soft. 

The air of the room should be kept moist 
by evaporating water over a spirit lamp, or, if 
that is not to be had, over the stove. To the 
water that is to be evaporated a little oil of 
Turpentine or oil of Eucalyptus may well be 
added. The cresoline lamp may be used. 

The throat should be kept clean with some 
antiseptic solution. Listerine diluted with 
water, one to ten parts of water may be used. 
Peroxide of Hydrogen may be employed pure 
or dilute used on a mop to remove the mem- 
brane and cleanse the walls of the throat. 

Borax may be used as directed, for sore 
mouth, as a mop to cleanse the throat and re- 
move the membrane. 

The germs in the membranes secrete a 
poison, which, when it becomes abundant 
enough, acts as a poison to the diphtheria 
germ itself, and the bacillus dies poisoned 
by its own toxine. The question is, will the 
poison secreted by the diphtheria germ kill 
the child or the germ first? If the child has 
sufficient strength the germ will be the first 
to perish. With this object in view Anti- 
toxine is administered, that while the child 



42 MEDICAL HANDBOOK. 

is yet strong by adding to the poison the diph- 
theria germs are secreting, the same poison 
obtained elsewhere, the two combined will de- 
stroy the germs of diphtheria before the 
child becomes so weak as to succumb itself. 
Antitoxine is strongly to be advised early in 
the disease, but not after the child is very 
weak. 



DROPSY. 

Dropsy is the collection of more than the 
normal amount of water in the tissues of the 
body. Dropsy may affect the hands and feet, 
the abdomen or the whole body. 

The cause of dropsy may be found in the 
circulation ; when the heart is weak, water es- 
capes through the small blood vessels into the 
tissues. In kidney disease the water is not 
thrown off in sufficient quantities and is held 
back in the system. Liver disease may cause 
dropsy of the abdomen by obstructing the cir- 
culation of the abdomen and causing the 
watery elements of the blood to escape into 
the abdomen, where the resistance is not as 
great as it is to pass the liver. 

Treatment. — It may be necessary to remove 
some of the water to give comfort to th/e 
patient. This may be done by sweat-baths in 
the sweating cabinet or by purgation, remov- 
ing much of the water by the bowels. To re- 



DIARRHOEA. 43 

move dropsical effusions by purgation no pur- 
gative is superior to Epsom Salts, y 2 ounce, 
two or three times a day. The kidneys may 
be called upon for extra work, if the dropsy is 
not caused by the kidney. Cream of Tartar, 
often found in the household, in 15 grain 
doses repeated three times a day will often 
assist in securing more work from the kid- 
neys. Diuretin or other drugs prepared with 
a view to act on the kidneys may be given. 
Gin or the Spiritus Juniperi U. S. P. are both 
valuable diuretics. One to 4 teaspoonfuls of 
the gin, and ^ to 1 teaspoonful of the Juniper 
Spirits may be given at a dose and repeated 
every three hours. 

It is important after doing something to re- 
lieve the dropsical condition to do something 
to remove the cause. Heart tonics are very 
frequently called for to restore the circulation 
to its normal condition. 



DTARRH(EA. 

Diarrhoea is a symptom of many diseased 
conditions and is recognized by the passage of 
frequent liquid or semi-liquid stools. It is a 
symptom of many diseases at the time of their 
onset, and a later symptom of other affections. 
It may result from mental excitement or from 
purgative drugs, a change in the temperature 



44 MEDICAL HANDBOOK. 

or the ingestion of unwholesome food, such as 
unripe fruit or dishes that are tainted by de- 
composition. 

The acute form of diarrhoea is nature's ef- 
fort to throw off an offensive burden on the 
digestive tract. Much undigested food in the 
movements indicates that the trouble is in 
the upper bowel, and much mucus points to 
the lower bowel as the seat of trouble. 

Treatment. — The food should be withheld 
for a meal or two, and it is good practice to 
give : 

1$. Calomel, 3 grains, and an enema of 
salt water. 

If there is much undigested food the Calo- 
mel alone may suffice ; but if the lower bowel 
is affected and there is much mucus the 
enema should also be given. After six or 
eight hours, when the bowel is thoroughly 
empty of its irritating contents : 

JJ. Bismuth Subnitrate, 10 grains. Powder. 

Give one powder every three hours until 
four doses have been taken. Or 

R. Laudanum, 10 drops, in water. 

Give the Laudanum at intervals of three 
hours, and if necessary give three or four of 
the 10-drop doses ; but in no instance should 
the Laudanum be given to babes or children, 
as they are very susceptible to the drug. 

A liquid diet of boiled milk is the best food 
to be given until the bowels are back to their 



DIARRHOEA. 45 

normal condition. On resuming solid food 
avoid fruits. 

DISCHARGES FROM THE BOWELS. 

The bowel movements of a child at birth are 
as a rule green. In a babe that is nursing the 
movement is light yellow and soft. During 
dentition the stools are apt to be frothy or 
greenish as a result of disturbed digestion. 
Some drugs color the stool. Much undigested 
food in the bowel movement indicates that the 
stomach and small intestines are not working 
right. If there is much mucus in the move- 
ments the trouble is in the lower bowel. Very 
light colored movements indicate that there is 
a lack of bile, and much dark coloring of the 
faeces would lead one to think there is an ex- 
cess of bile. Frothy or offensive movements* 
indicate fermentive indigestion and irritation 
of the small intestines. Flattened faeces indi- 
cate some obstruction of the rectum usually 
from pressure from surrounding structures. 
Small stools may indicate stricture of the rec- 
tum. 



DENTITION OR TEETHING. 

"The teeth appear in the following order : 
6th to 8th month, the two lower middle incisors ; 
8th to ioth month, the four upper incisors ; 
1 2th to 14th month, the two lateral lower in- 
cisors, and the four first molars ; 18th to 20th 
month, the four canines ; the 28th to 32d 
month, the four second molars." — Rotch. 

The appearance of the teeth is influenced 
by the health of the child and is delayed by 
rachitis. Much variation in the date of the 
appearance of the teeth often occurs, with no 
diseased condition of the child as an explana- 
tion. Difficult teething may be accompanied 
by convulsions. For the convulsions give the 
child a hot bath and afterward remove the 
cause by incising or lancing the gum above 
the troublesome tooth. Disturbances of diges- 
tion are very common during teething, possi- 
bly influenced by the appearance of the teeth, 
and in many cases simply due to improper 
feeding and a lack of care as to what the child 
bites on or chews at to press the gums upon. 
Diarrhoea is the most common trouble, and 
when of a foul, foetid odor should not be 
stopped too soon, as the poisonous contents of 
the bowel may be retained to the injury of the 
child. If not dangerously severe the diar- 
rhoea is not to be looked upon with alarm; 



DISTURBANCES OF DIGESTION. 47 

often a thorough emptying of the bowel by a 
dose of Castor oil, followed by from two to 
four grains of Subnitrate of Bismuth, every 
three hours, may stop the diarrhoea. The food 
should be discontinued for six hours and when 
resumed let it be of boiled milk, and for older 
children brown flour gruel may be added to 
the milk diet. Gradually go back to a mixed 
diet. 



DISTURBANCES OF DIGESTION. 

Furring of the tongue is looked upon as a 
sign of disturbed digestion. Low fevers and 
general atonic conditions of the system are 
generally accompanied by a furred tongue. A 
gray-coated tongue which is flabby and coated 
only on the edges is said to indicate gastric 
or intestinal catarrh. Sleeping with the mouth 
open will cause furring of the tongue. In some 
forms of sore throat the tongue is furred. In 
the malignant fevers the tongue is coated dark 
brown to almost black and is often very dry. 
A thick swollen tongue, showing the imprints 
of the teeth and coated white, is seen in ab- 
dominal affections and in appendicitis. 

VOMITING. 

In babes vomiting, unless prolonged, is not 
of much consequence and may be due to rapid 



48 MEDICAI, HANDBOOK. 

feeding or some slight gastric disturbance. If 
there is vomiting associated with colic, with- 
hold the food for a short time and give a dose 
of Castor oil. Vomiting in older children and 
adults may be due to nauseating food, tepid 
drinks, worms, biliary colic and pregnancy. 
Vomiting without previous nausea and which 
expels the food as if thrown from the patient 
is indicative of brain trouble and may follow 
injuries to the head or accompany brain dis- 
eases. 

Treatment. — The treatment of vomiting is 
rest of the stomach and occasionally mild 
stimulants. The stimulants best given are hot 
water or bits of ice, coffee, brandy and acid 
drinks. 



HICCOUGH. 

Hiccough is, as a rule, of minor importance, 
but to the weak and enfeebled it is often very 
distressing and sometimes injurious. Hic- 
cough is frequently caused by too rapid eating 
of hot food, and in such cases a few sips of 
water will usually suffice for a cure. When 
associated with abdominal affections and low 
forms of disease, it is no minor complication to 
treat. For such cases allow the patient to 
suck ice. A teaspoonful of salt in vinegar 
makes a good solution to give for hiccough; 



coivic. 49 

give small quantities, but do not repeat too 
often. Morphine, %. grain for an adult, may be 
required in some cases, and even small amounts 
of Chloroform may have to be given. When 
the patient is strong, if sips of water fail to 
cure, have him hold his breath for a little 
while, and if this fails have him tickle his nose 
with something; the sneezing which follows 
usually stops the hiccough. 



COLIC. 

Colic is usually a result of irritant food, of 
flatulence, of faecal accumulations and of lead 
poisonings. The symptoms are paroxysms of 
twisting pain around the navel which is tern 
porarily relieved by pressure, and permanently 
relieved by the expulsion of the faeces or 
flatus. In lead colic there are blue lines 
around the teeth on the gums. Infantile colic 
is usually a result of indigestion. 

Tteatment. — To remove the cause it is 
clear that the offending contents of the stom- 
ach and bowels should be removed. In some 
instances an emetic and in others a prompt 
purge are the most advisable treatment. While 
the purge is acting it may be necessary to 
temporarily relieve the pain by a dose of Mor- 
phine from Y% to % grain, or Laudanum, ten 
to twenty drops. Do not give Laudanum or 
Morphine to children for colic. One or two 



50 MKDICAI, HANDBOOK. 

drops of the Oil of Peppermint, with or with- 
out the same amount of Tr. Colocynthis, may 
be given every fifteen minutes until relief is 
experienced, or two or three doses have been 
given. Heat or pressure to the abdomen is 
very soothing and beneficial. For the colic of 
babies, rest the stomach against the hot water 
bottle and internally give hot Chamomile tea 
or a few drops of hot brandy in hot water, or 
a few drops of the Oil of Peppermint in hot 
water, give about ~%. drop of Peppermint at a 
dose for three or four doses. Give the child a 
dose of Castor oil and guard the feeding that 
the attack is not repeated. 

Hot compresses wrung out of hot water, on 
which a little Turpentine may be sprinkled, 
often give prompt relief when applied to trie 
abdomen. 



DIGESTIVE SYSTEM. 

DYSPEPSIA. 

There are several varieties of dyspepsia. The 
disease is common at all ages and in all cli- 
mates. 

Acute Dyspepsia. — The causes of acute dys- 
pepsia if well understood will assist much in 
the proper care of those suffering from the 
same. Rapid eating, or eating more than the 



DYSPEPSIA. 5 1 

digestion can care for, are common causes. 
Foods that have undergone fermentative 
changes, alcoholic drinks and mental and 
physical exhaustion are also important in 
causing dyspepsia. 

Symptoms. — Coated tongue, fulness and dis- 
tress in the abdomen, eructation or belching, 
dizziness, nausea and often vomiting, flatu- 
lence and colicky pains. In children fever and 
diarrhoea are common. 

Treatment. — Recovery usually occurs in 
twenty-four hours, even if no medicine is 
given ; but much can be done for the comfort 
of the patient. If there is nausea or vomiting, 
a glass of warm water will assist the stomach 
to rid itself of the offending burden. For chil- 
dren a dose of Castor oil should be given, and 
adults should take some prompt cathartic. If 
there is much acidity of the stomach : 

If . Soda i teaspoonful. 

Water Y / 2 cup. 

Stir, and take two or three teaspoonfuls 
and repeat in a short time if necessary, or 

I£. Tincture of Nux vomica, i to 3 
drops, taken on sugar. Sometimes, 

Tfy. Quinine sulphate, 3 grs. 
is given instead of the Nux vomica. 

Food should be withheld for one or two 
meals. The error in diet sought for and cor- 
rected, and food selected that will not irritate 
the stomach. 



ERYSIPELAS. 

Erysipelas is an acute contagious disease. 
After exposure the disease may develop in 
from two to seven days. 

Those suffering with erysipelas should be 
careful not to infect others by the use of the 
same towels, wash basins or any article that 
touch or come in contact with those not in- 
fected. No one should go from the room of 
an erysipelas patient into the lying-in cham- 
ber, as the mother is very apt to become in- 
fected, and the most dire results follow. 

The eruption of erysipelas is preceded by 
slight constitutional disturbances ; languor, 
chilliness and tingling of the affected part are 
apt to be present. The pulse quickens. The 
tongue is coated. The appetite lost and the 
urine scant and high colored. 

The eruption usually begins on the face, is 
bright red, swollen. Tense and has sharply 
defined edges. The surface is first smooth 
and glossy; but later is covered with vesicles. 
There is swelling of the surrounding parts. 
The disease spreads from the edges. 

Erysipelas seldom lasts longer than a week 
or ten days, half of which time the disease re- 
quires to fully develop, the other half to grad- 
ually disappear. There is scaling of the af- 
fected areas after recovery is well advanced. 



ECZEMA. 53 

Relapses are common, and one attack predis- 
poses to another. 

Treatment. — Isolate the patient. Require 
complete rest, give nourishing food, and some 
tonic, such as Nux vomica, three tablets three 
times a day, or five grains of Quinine three 
times a day. Keep the bowels moving freely. 
Antiseptic application may be applied to the 
part, of which the Bichloride of Mercury 
V4000 * s as £°°d as any. Iodine is at times 
painted around the infected area with a hope 
to stop the spreading. Lead Water and Laud- 
anum may be used as an application. The 
salve given as a healing salve may be spread 
on lint and applied to the affected area. 



ECZEMA, OR TETTER. 

Eczema is not a contagious disease, but is 
more a constitutional affection. Eczema is 
characterized by papules, vesicles, pustules, 
scales and crust. More or less watery dis- 
charge and. continuous itching. 

The causes of eczema are anything that 
lowers the vitality. External irritants like 
hard soap often provoke eczema among in- 
fants and babes. Heat and cold may cause an 
eczematous eruption. Dyspepsia may be an 
exciting cause. In nursing babes or bottle-fed 
infants eczema may result from improper con- 



54 MEDICAI, HANDBOOK. 

stituents of the food. An infant suffering 
from eczema as a result of improper diet will 
usually show signs of indigestion, or be 
chronically constipated. Where the food is at 
fault there must be a change of diet before 
remedies will act. 

Eczema may be in irregular patches on the 
face, or vesicle or papules on the extremities. 
There may be poorly defined patches sur- 
rounded by many vesicles that break and leave 
a raw surface. There may be pustules that 
rupture and form crusts. In the scalp there 
are usually patches covered by crusts or scales. 

Eczema has for the one and ever present 
symptom itching, no matter if the eruption is 
vesicular, pustular or crusting. No matter 
where the location is the itching is always 
present. 

Treatment. — Improve the health. Avoid 
salt meats, pickles, pastries, cheese. Irritant 
soaps. Leave no part moist after washing and, 
indeed, too frequent washing is to be avoided. 
The digestion should be favored in every way. 
The bowels kept moving regularly, and exer- 
cise in the open air should be encouraged. 

Bottle-fed babies should have a change of 
food and if constipated see that more cream is 
added to the milk or give a teaspoonful of 
Olive oil twice a day with the milk that the 
bowels be kept moving more freely. 



EARACHE. 55 

For the itching: 

J$ . Salicylic acid 5 grains. 

Olive oil i ounce. 

Shake well and rub on the itching surface. 
Or, 

^. Carbolic acid i drachm. 

Glycerine 2 drachms. 

Water 8 ounces. 

Shake well and bathe the itching surface. 
Zinc oxide may be applied to the crusts or 
itching parts and left as a covering or oint- 
ment. It is well at times to remove the scales 
and cleanse the parts. It is not necessary to 
use water, as one of the above preparations 
may be used to soften the scales and then by 
carefully rubbing the part may be cleansed. 



EARACHE. 

Earache may be due to some foreign body in 
the ear. To the accumulation of ear wax, and 
to inflammation of the middle ear. 

There is very often an abscess to open and 
discharge. At times following exposure to 
cold, severe earache may result without the 
formation of any abscess or discharge. 

The pain is intense and very fatiguing. 
The child will all of a sudden start and scream 
and be in intense agony. Presently the pain 
will cease and sleep may follow, only to be 
aroused again by the intense pain of another 



56 MEDICAL HANDBOOK. 

paroxysm. Finally, if an abscess be present, 
rupture will take place and permanent relief 
be afforded. 

Earache may last from one to two hours, to 
one or two days. 

Treatment. — Hot applications held to the 
side of the head often give prompt relief. 

Place a few drops of Chloroform on a little 
cotton and place the cotton in the bowl of a 
pipe. Blow the Chloroform into the ear 
through the stem of the pipe. 

In the same way blowing tobacco smoke 
into the ear often gives relief. 

Laudanum, Glycerine and Olive oil mixed 
in equal parts may be dropped into the ear. 
Drop a few drops into the ear and allow to 
remain a short time and then let run out. 

Middle ear disease is so serious an affection 
that if repeated attacks of earache are 
followed by an offensive discharge from the 
ear the time for home remedies ceases and 
medical attention is strongly to be advised. 



CONJUNCTIVITIS, OR SORE EYES. 

The eyes may become sore from several 
causes. Infection of the mucous membrane of 
the eyes with some of the pus forming germs 
is common. Infants may suffer from a severe 
form of sore eye contracted from a diseased 
genital tract of the mother. 



CONJUNCTIVITIS. 57 

Raw, cold wind of spring often acts as an 
exciting cause, producing inflammation of the 
conjunctiva or mucous membrane of the eye. 
xA.ssociated with snow-blindness is always con- 
junctivitis. Some of the deeper and more 
serious affections of the eye have an accom- 
panying inflammation of the conjunctiva. 

The symptoms are watering of the eye. A 
sensation of sand in the eye, pain and dread of 
light. 

Treatment. — Cleanliness is of prime im- 
portance. Some antiseptic solution should be 
dropped in the eye every three to six hours. 

The Sulphate of Copper one per cent, solu- 
tion, or one grain to one and a half teaspoon- 
fuls of water, is a very safe and reliable reme- 
dy, Drop a few drops in the eye three or four 
times a day. 

Boracic acid solution as much as the water 
will absorb, is also a safe and reliable remedy. 
Place a few drops in the eye four or five times 
a day. 

Keep the eye cleansed by bathing the lids 
in warm soap water. And w r ash out the eye 
at short intervals (every two hours) with the 
Boric acid solution if there is pus or a puru- 
lent discharge. 



FACE AND EYES. 

The colors of the face vary in health. Nor- 
mal darkening is found after exposure to the 
wind and sun, and normal bleaching of color 
after continued housing. A yellowness of the 
white of the eye indicates jaundice before the 
skin appears yellow. The white of the eye may 
become quite red from the straining during a 
paroxysm of whooping cough. Dark lines un- 
der the eyes may indicate a disturbance of the 
digestion, worms in children, a disturbance of 
the sexual functions, and the result of late 
hours and little sleep. Puffiness under the eyes 
is met with in some forms of kidney disease 
and from exposure to cold and wind, also 
from crying and from sleeping long in a poorly 
ventilated room. Yellow coloring of the 
face may be due to jaundice, or, in a slight 
degree, to biliousness. Waxy paleness of the 
face is met with in consumption and almost all 
of the constitutional diseases that are of a 
chronic character. A bright red spot on one 
of the cheeks over the cheek-bone is common 
in advanced stages of consumption. This is 
not the bright rosy flush so common in health 
during youth and early adolescence. Flush- 
ing of the face is met with in fevers. Transi- 
tory flushes are common at the climacteric. 
Blueness of the lips may be due to poor cir- 
culation. 



COLD, FROST-BITE, CHILBLAIN. 

On going into intense cold there is a sensa- 
tion of obstructed breathing, as if the passages 
of the nose were narrowed, simultaneously 
also is a slight rawness and fulness of the 
chest. Reaction in the nose soon follows, and 
a watery discharge is very common as a result 
of the hyperemia of the mucous membrane. 
Slight cough and expectoration is noted in 
some. The breathing then becomes free, and 
remains so during the exposure to the cold. 
Localities exposed to the cold at first tingle 
and show a lack of blood. The setting of the 
blood inward congests the brain and frontal 
headache follows ; with the reaction and return 
of blood to the parts the headache subsides and 
a sense of faintness and nausea is often felt, 
which again rapidly subsides as the circulation 
becomes full and strong under the stimulating 
influence of the cold. For a time all of the 
natural powers combine to combat the inroads 
of cold, and the individual is alert to every 
pain and pang from without and within. 
There may even be anxiety. Finally the head- 
ache is again felt, there are chilly spells, one 
part after another tingles from cold; finally 
the tingling lessens and numbness and weight 
of the limbs follow. The mind is prone to 
reverie and to a sense of security; the cold 
is noted, but the desire to ward it off is gone, 



60 MEDICAI, HANDBOOK. 

and there is a strong desire to sit or recline 
and allow the mind to continue its thoughts. 
Drowsiness follows and an almost irresistible 
desire comes to sleep, and at the same time the 
sensation in the limbs is lost. The individual 
may know that he is freezing, but the will is 
too weak to rouse the body to action. Unless 
aid soon comes to such a one death is immi- 
nent. Nature has exhausted her vital power 
and with the exhaustion the heart slows, and 
so does the respiration, and life's fire goes 
out. Those rescued, or even those suffering 
from cold and returning to a warm place, must 
observe care lest the congestion of the internal 
organs be relieved too quickly, and fainting or 
even death follow the setting of the blood to 
the surface, caused by the return of the cir- 
culation of the surface, leaving the heart, in- 
ternal organs and brain with too little blood. 
To stimulate the lungs and heart, and retain 
part of the circulation in the internal organs, 
nothing surpasses hot drinks, and of these hot 
tea is to be given preference. 

FROST-BITE. 

The sensation of cold is followed by tingling 
and aching of the part affected. Numbness 
and a sense of weight is noted and then all 
sensation is lost. On examination the part is 
white, stiff and frozen. So insidious is the in- 
road of cold that a frosted area may remain 
frozen for hours and the individual have not 



FROST bite;. 6i 

the slightest knowledge of cold, pain or dis- 
comfort. The action of frost is, first, by direct 
injury to the tissues, and second and more 
noteworthy, the injury to the nerves that con- 
trol the local circulation of the frosted area. 
Rapid restoration to the normal temperature is 
followed by inflammation, slough and gan- 
grene. An individual with a frozen finger, toe 
or extremity should first be taken into a room 
that is scarcely above the freezing point, bund- 
ling with clothing sufficient to keep the body 
warm ; the frozen part should then be rubbed 
with snow or immersed in ice water and gent- 
ly rubbed while the frost is coming out. Gen- 
tle friction is necessary as the circulation re- 
turns ; the least engorgement and stasis of the 
blood result in death of the part or gangrene. 
For a short time after the frost is out the 
rubbing should continue. After this first step 
the patient may be put to bed in a cool room. 
The frosted member should be elevated so that 
the arterial circulation is retarded and the 
venous circulation is assisted from the part by 
gravity. The limb should be left in an elevated 
position for several days, open to the air with 
neither cover nor dressings. The room must 
be kept cool (40 to 50 degrees F.). Allow the 
patient plenty of bedding that the room need 
not be kept warm. If the frost-bite has been 
superficial cold compresses of Lead-water 
and Laudanum will be soothing and assist in 
preventing inflammation. If the deeper struct- 



62 MEDICAI, HANDBOOK. 

ures have suffered from the cold, the Lead- 
water and Laudanum should not be used, but 
at intervals of two or three hours alcohol should 
be applied to the part, using gentle friction to 
stimulate the circulation. For two or three 
days the appearance may be quite normal and 
then, without apparent cause, suddenly the 
part may become inflamed and swollen, and 
later blacken and become dead and gangrene 
set in. If slough or gangrene develops the in- 
jured locality should be covered with a light 
dressing for a few days until the line of de 
markation is established between the part that 
is going to recover and the part that is hope- 
lessly injured. The nerves are slow to recover 
after being frosted, and for this reason do not 
control the capillary bloodvessels, allowing of 
local congestion and distension. Above the in- 
jury the normal veins are not sufficient to 
carry away the excess of blood, and in the seat 
of injury the veins are distended, through 
walls of which exudation easily follows ana 
restoration is retarded, finally ceases and gan- 
grene ensues. The line of demarkation in 
superficial injuries is back of that in the 
deeper structures, making the stump of healthy 
tissue convex; but where the injur}' has been 
deep and of some hours' duration the reverse 
of this condition is to be found and the stump 
is concave. The bone least of all the tissue 
regains its vitality. Operations to remove 
frozen fingers, toes or extremities must be per- 



CHILBLAINS. 63 

formed well back of the line of demarkation, 
especially is this true of the bone, lest a sec- 
ond operation be necessary before the desired 
result is obtained. 

Frosted tissues are low in vitality and henl- 
ing may be retarded. Primary union cannot 
be expected as often as in operations on more 
healthy structures. 

CHILBLAIN. 

Parts that have been frosted or exposed to 
cold for some time and then rapidly warmed 
behave in a peculiar manner and thus claim 
separate consideration. Hyperesthesia of the 
affected area is the prominent feature of the 
trouble. The injury is more of the nerves than 
of the tissues. A rapid rise of temeprature in 
the part, with or without previous exposure to 
cold, may cause very annoying symptoms of 
burning and itching, with reddening and more 
or less swelling. Moist heat (the bath), the 
heat of heavy clothing, and sudden changes 
in the temperature are all causes that may 
excite the sensation of burning and itch- 
ing. The treatment of such cases should be 
first directed to the prevention of rapid 
changes of temperature of the part affected. 
When local irritation is present the itching 
and pain may be arrested by the application of 
cold compresses wet with Lead-water and 
Laudanum, or by painting the part with the 
Fl. Ext. of Belladonna. Directing the treat- 



64 MEDICAI, HANDBOOK. 

ment to the injured nerves, massage and the 
use of astringent liniments are of value be- 
tween the times of irritation. All parts that 
have been frozen are sensitive to cold for some 
time and should be given massage to restore 
the functional activity of the vessels, nerves 
and tissues of the part. 



FRACTURES. 

Fractures may be complete or incomplete, or 
simple or compound. Fractures may be trans- 
verse, longitudinal, or diagonal. In the elbow 
we may have a fracture separating the bone 
lengthwise. The shaft of any long bone may 
break in a transverse or cross fracture, or the 
break may be in a diagonal direction. 

The symptoms of fracture are pain, more 
than normal mobility, shortening of the limb, 
and a peculiar grating of the ends of the bone 
at the seat of the fracture. The muscles of the 
body have a continual tendency to draw to- 
gether and are like rubber bands pulling on 
both sides of a bone. When fracture takes 
place the lower fragment is drawn up and 
made to override the upper fragments, causing 
shortening. To set a limb it will be necessary 
to overcome the contractility of the muscles 
and replace the fragments, coapting them in 
their normal position. The dressing should be 
firm but not too tight. Where the joints are 
involved it is always best to place the limb in 



FRACTURES. 65 

such a position that should the joint be stiff 
on healing the utility of the limb will be im- 
paired as little as possible. Thus the elbow if 
involved in a fracture should be dressed with a 
splint of such an angle that the hand can be 
brought to the opposite shoulder. The knee, 
if injured, should be dressed in a slightly 
flexed position, which will be better for walk- 
ing and sitting than a straight limb. 

Fractures of the arm are common and may 
be of one or of both bones. If of one bone, 
draw the hand and lower fragment toward the 
side of the sound bone and slip the ends of the 
bone in apposition. 

If there is a break of one or both bones of the 
forearm and the break is below the middle of 
the arm the hand may be placed against the 
abdomen and an internal angular splint ap- 
plied, leaving the arm at right angles and us- 
ing a splint that has a right angle and is band- 
aged to the arm above the elbow. Use a wide 
splint so as not to draw the fragments of the 
bone against the other bone by the pressure on 
the sides of the arm. If the fracture is of the 
upper part of the forearm, it may be necessary 
to bandage the arm to a splint with the palm 
of the hand up. This is occasioned when the 
bone on the thumb side of the arm is broken 
well to the upper end. 

In breaks of the thigh it is necessary to 
overcome the action of the muscles, and the 



66 MKDICAI, HANDBOOK. 

thigh in particular is hard to deal with because 
of the powerful muscles involved. For this a 
double incline plane or a V-shaped splint should 
be used ; the weight of the body will draw down 
while the knee is over the angle of the splint 
and some of the action of the muscles will be 
overcome. In fractures of the leg the position 
of the foot is to be borne in mind. Keep the 
toes pointing directly up. Shortening will re- 
sult from most fractures, but no one will for- 
give you if the toe points in or out. 

If a fractured bone breaks through the mus- 
cles and skin, the danger is greatly increased 
lest infection follow and serious trouble arise. 
If such should occur use the most rigid anti- 
septic measures in cleansing and dressing the 
wound. Apply such a splint and dressing that, 
if need be, the wound can be attended to or re- 
dressed without removing the splint. 

Remember, a shortened limb, if in the nor- 
mal position, is a useful limb; that a stiff joint 
is best if slightly bent; and that a compound 
fracture demands extra care and cleanliness. 



FAINTING AND LOSS OF 
CONSCIOUSNESS. 

Dizziness and fainting are common symp- 
toms and not diseases, due to anaemia of the 
brain or want of blood in the brain. If the cir- 
culation be drawn elsewhere, leaving the brain 
deficient in blood supply, the functions of the 
brain cannot be performed and the resulting 
symptoms are dimming of vision, nausea, dizzi- 
ness, intense weakness and finally fainting or 
loss of consciousness. Besides a weak heart, 
fear and emotional excitement may cause the 
circulation to go elsewhere than to the head 
and fainting results, even if the heart is strong. 

Treatment. — Nature acts wisely by causing 
a person that faints to become unconscious and 
fall. In the erect position the blood gravitates 
from the head and a weak heart cannot send 
the blood to the head ; for this reason the posi- 
tion for one who feels faint or has fainted is 
not standing or sitting, but lying with, per- 
haps, the head slightly lower than the body. 
Undo the clothing about the neck and chest 
that the breathing and circulation may be un- 
hampered. Some stimulating drug may be in- 
haled that, by acting on the nerves in a reflex 
manner, it will stimulate the heart to stronger 
action. The Aromatic Spirits of Ammonia is 



68 MEDICAL HANDBOOK. 

one of the best stimulants of this kind. Heart 
tonics, such as brandy or Strychnine, may be 
used in medicinal doses. 

Coma, or unconsciousness, may be caused by 
injuries to the head, epilepsy, apoplexy, sun- 
stroke, drug-poisoning and uraemia or kidney 
disease. In coma there may be no lack of 
blood to the brain. Consciousness does not 
speedily return as it does in fainting. 

The cause should be removed if possible in 
treating cases of coma. 



NORMAL HEART ACTION. 

The normal pulse of an infant at birth Is 
from 130 to 140 per minute; about the third 
year, 90 or 100; and the fourteenth year, 80 or 
85. The normal adult pulse is usually given as 
72 per minute, but in the old the heart slows to 
65 or even 60. There is quite a range between 
the normal pulse of different persons ; thus 70 
may be normal for one and 80 for another. 
The pulse of women is normally about ten 
beats quicker than that of men. The standing 
position will raise the pulse ten or more beais 
per minute and active exercise will take it to 
100 or even more in the normal adult. The 
pulse is increased by fevers, corresponding to 
the height of the fever. A quick, hard pulse 
indicates more the infectious fevers, and a 
quick, full and bounding pulse accompanies in- 



HEART DISEASE. 69 

flammation, and the febrile state of low dis- 
ease, where there is absorption of poisonous 
disease products. A changeable pulse is met 
with in tobacco users and those suffering from 
nervous disorders. A slow pulse is common 
with fainting, brain diseases that are febrile, 
and tumors of, on injury to the brain, A fine, a 
scarcely perceptible, pulse is common as death 
approaches. 



HEART DISEASE. 

In speaking of the diseases of the heart we 
would divide them into two classes : First, 
those affecting the heart itself, and second 
those disorders that have symptoms referable 
to the heart, but in which the heart is not the 
seat of the disease, but is only affected through 
the nervous system. 

ORGANIC HEART TROUBLE. 

Causes. — Pneumonia and rheumatism more 
often than any other diseases cause valvular 
disease of the heart. Other affections such as 
typhoid fever or scarlet fever, etc., play a 
minor role in causing this trouble. 

7ne disease seldom exists except as a result 
of some other affection. The poison, or the 
germs themselves, of some disease acting on 
the inner walls of the heart and its valves pro- 



70 MEDICAX, HANDBOOK. 

duce inflammatory changes, which on healing 
obstruct the openings of the heart, or the free 
action of its valves. 

Symptoms. — The symptoms of inflammation 
of the inner heart walls are vague and often 
not noticed at the time of the sickness that 
causes the injury to the heart. After rheuma- 
tism, pneumonia, typhoid fever or any of the 
infectious diseases endocarditis may exist. 
Shortness of breath on exertion and conscious- 
ness of the heart's action should lead you to 
suspect some involvement of the heart. If 
such exists, care should be exercised that the 
heart is not strained in any way until time has 
been given it to recover, or for compensation to 
take place. When the valves become deranged 
the normal heart work is obstructed and a train 
of symptoms are produced. The blood is 
dammed back into the lungs and shortness of 
breath ensues, cough, expectoration and even 
blood-spitting may result, caused by the en- 
gorgement of the lungs. Headache and dizzi- 
ness may be caused by a lack of blood to the 
head. Dropsy may be present and is most 
likely to be noticed on the feet or ankles first, 
the urine becomes scanty and high-colored, 
and the digestion badly imparled, i. e., there 
will be dyspeptic symptoms. 

Treatment. — The first object to be sought 
is the repair of the heart, and this must be 
done by nature herself and the patient must 



HEART DISEASE. 7 1 

not hinder this very important process. Avoid 
over-exertion, such as running up stairs, heavy 
lifting or straining caused by allowing the 
bowels to become constipated. The patient 
should have plenty of fresh air and sunshine. 
Good easily digested food and lastly medicine. 

There is probably no drug better than 

J^. Tincture Strophanthus. One drop in 
water, or one tablet three times a day. 

Strophanthus acts on the heart, stimulating 
the muscle itself, and is beneficial in assisting 
the heart to gain strength. Acting on the gen- 
eral circulation it assists much in relieving the 
distress of the various organs secondarily af- 
fected from an improper blood supply. 

Ranking with Strophanthus and, in fact, an 
older drug known and used for this same 
trouble is Digitalis, which drug may be chosen 
over the former in cases where the heart's 
action is rapid and weak, and the urine scanty 
and high colored. 

1^. Tr. Digitalis, three drops. Give on 
sugar, three times a day. 

I prefer to give the Digitalis for only a short 
period, say, one week, and then turn to the 
Strophanthus. As symptoms subside stop the 
drugs. 



HEADACHE. 

Headache is a symptom of many affections 
and by itself can hardly be successfully treated. 
Pain in the head usually results from some dis- 
turbance of the circulation to the head, from 
tumors of the brain, from inflammatory dis- 
eases of the brain or its meninges, and last, 
but not least, from reflex nervous irritation, of 
causes acting in distant parts of the body, as 
disturbances of digestion, eye strain, nasal 
catarrh, and disturbances of the reproductive 
functions or organs. 

Headache due to meningitis, tumor, abscess, 
and diseases of brain substances are usually 
associated with disturbances of vision, paraly- 
sis and mental aberrations. 

Headache due to congestion of the brain, as 
in fevers, sun-stroke, over mental work and 
obstruction of the return circulation of blood 
from the brain, have, as symptoms, pain in the 
head of an intense throbbing nature. The face 
is hot and flushed, the eyes glossy and injected, 
and the pain is made worse by excitement, 
motion or stooping. There may be a headache 
from want of blood to the brain caused by poor 
circulation, which will be associated with 
signs of poor circulation, such as cold ex- 
tremities and fainting spells. A headache 
caused by lack of blood to the brain will be as 



HEADACHE. 73 

of a weight on the head; the face pale, the 
pulse weak, and the inhaling of stimulating 
drugs or the lowering of the head will be at- 
tended with relief of pain in the head. 

Headache may result from poisons in the 
blood, from ursemic conditions and any state 
where, from disease, there is a product that 
should be thrown off by the system, but for 
some reason is retained and absorbed by the 
blood. Irritating the head and producing 
headache, as by irritating the nerves of the 
body, the poison may produce rheumatic 
pains. 

Headache still may be and more often is 
produced by reflex nervous irritation than by 
any other cause. Disturbances of digestion in 
a reflex manner excite more headaches than 
any other given thing. Where the digestion 
is at fault the headache will be relieved by 
vomiting or the administration of something 
to stimulate the action of the stomach and 
bowels. 

Diseases of the female reproductive organs 
may cause headache, which is worse at the 
time of the menses. The headache of disturb- 
ances peculiar to women will be worse on top 
of the head. There is a feeling as if the top 
of the head would fly off and pain is relieved 
by pressure. 

Treatment. — If the headache is due to re- 
flex causes, such as indigestion, give Tr. Nux 
vomica, three drops, or three tablets, for two 



74 M3DICAI, HANDBOOK. 

or three doses. There is often very prompt 
relief from the headache of indigestion if the 
stomach is relieved by an emetic. A prompt 
acting purge will often do wonders by ridding 
the stomach and bowels of an unwelcome 
burden. 

If the headache is due to congestion of the 
brain, cold applications to the head and a hot 
foot bath will aid materially in the relief of 
the pain. 

If the circulation is poor and the headache 
is due to want of blood to the brain, stimulat- 
ing smelling salts and hot drinks or heart 
tonics will aid materially in giving relief. 

If the eyes are at fault, secure proper 
glasses. 

No treatment will afford permanent relief 
unless it be directed at the original cause. 
Headache powders are numerous, but are only 
a poor excuse at treatment and will not result 
in a cure. 



HIVES, OR URTICARIA. 

Hives are usually caused by gastrointesti- 
nal disorders. Emotion and excitement pre- 
dispose to hives. Certain foods are apt to 
cause an eruption of wheals or hives on some 
persons, while on others the same food may 
cause no disturbance. 

Hives appear suddenly and are as small red 



HEMORRHOIDS, OR PII.KS. 75 

pimples, which are slightly elevated and itch 
intensely. 

Treatment. — If due to indigestion give a 
prompt acting purge and some tonic, such as 
Nux vomica 6, one to two tables every four 
hours. If the stomach is acid to such an ex- 
tent as to produce sour belching or heartburn, 
give Soda Bicarbonate, three grains after 
meals. Internally the Salicylate of Soda in 
four grain doses may be given three times a 
day. 

Locally, the itching may be relieved by 
bathing the itching areas with 

Jfy. Acid Carbolic, . .y 2 drachm. 

Glycerine, ^ ounce. 

Alcohol, 

Water, aa, 4 ounces. 

Shake well and bathe the itching surface. 

The itching of hives may often be relieved 
by bathing the surface with vinegar and water 
in equal parts. 

Chloroform and Alcohol, one part of the 
former to eight parts of Alcohol, make a very 
good soothing application. 



HEMORRHOIDS, OR PILES. 

Haemorrhoids, or piles, are bloody tumors 
of the lower end of the rectum. Piles are 
composed of dilated veins. The veins of the 
rectum have no valves as have the veins in 
other parts of the body, and anything that ob- 



76 MKDICAI, HANDBOOK. 

structs the refiow of blood predisposes to 
haemorrhoids. Pregnancy, sedentary habits, 
the excessive use of purgatives and constipa- 
tion are all common causes. Haemorrhoids 
may be internal or external. External piles 
are due to a varicose condition of the external 
haemorrhoidal veins, and are bluish rounded 
tumors, which can easily be emptied by press- 
ure. Fissues and eczema of the surrounding 
skin are not uncommon with external piles. 
The haemorrhoids, when inflamed, are ex- 
tremely painful to the touch. They seldom 
bleed, though occasionally they suppurate and 
form an abscess. Itching of the parts is com- 
mon. 

Treatment. — Whatever that causes the ob- 
struction of the refiow of blood when remov- 
ed will open the way for medical and surgical 
treatment. Constipation should be avoided. 
The parts kept clean. Hot sponging will often 
relieve the itching and pain. Astringent pile 
salve may help to reduce the swelling and 
pain. Tr. Belladonna and Glycerine may be 
mixed in equal proportions and painted on the 
piles, after which hot applications will assist 
in relieving the pain. The operative treatment 
gives rapid relief and permanent recovery. 
Incision and emptying the clot, followed by 
packing the cavity with gauze to control bleed- 
ing, is the best treatment. If there is a large 
haemorrhoidal mass excision of the entire mass 
or bloody tumors is the only sure form of re- 
lief. 



HEMORRHOIDS, OR PILKS. 77 

INTERNAL PILES. 

Internal piles are found within the rec- 
tum. The appearance is the same as an ex- 
ternal pile, only the tumor is covered with 
mucous membrane. The pile may also seem 
like a fold of the mucous membrane of the 
rectum. Internal piles are easily excited to 
bleeding by the irritation of the bowel move- 
ment. At first the bleeding only follows the 
passage of stool. Later in the course of time 
the bleeding may precede as well as follow 
the stool and may become a prolonged and 
troublesome condition. During defecation 
there is pain in the rectum and the pil»e 
mass easily protrudes through the sphincter 
ani, and if large may become strangulated 
and very painful and if not reduced slough 
away. 

Treatment. — Constipation must be avoid- 
ed by the use of laxatives and the regular 
movement of the bowels. Ensemas are very 
beneficial in some cases. After each stool 
the patient should wash the pile or pile mass 
and anoint them with an astringent oint- 
ment one time and the next time by some 
bland ointment ; after anointing the pile re- 
place in the rectum. Vaseline is good for 
the simple ointment, and Hamamelis and 
^sculus cerate mixed in equal parts is a 
splendid astringent ointment for the alternate 
application. 



78 MEDICAI, HANDBOOK. 

Operative treatment or the removal of the 
mass is the surest cure, but is only to be 
done by the surgeon. 

ITCH OR SCABIES. 

The itch is due to the presence of an 
animal parasite called the itch mite. The 
itch is always acquired by contact in some 
way with some one who has the itch. 

The male itch mite remains on the surface 
of the skin and may be seen by the use of 
a strong magnifying glass- The female bur- 
rows into the skin and lays her eggs, caus- 
ing the intense itching and the formation 
of vesicles and pustules. 

The symptoms are intense itching asso- 
ciated with the eruption of small papules, 
vesicles and pustules. The itching is worse 
at night when warm in bed. The parts first 
affected are the hands between the fingers, 
the« the wrists, then the genitalia, the inner 
surface of the thighs and the chest beneath 
the mamma. All of the body may become 
involved except the face, which remains free. 

Treatment. — The destruction of the para- 
site is the only hope of a cure. There is 
no seven-year itch, but a case may last that 
long or longer unless treated. When the 
parasite is dead the disease is cured, be the 
time short or long. 

Either of the following applications will 
cure: 



INFLUENZA OR GRIPPE. 79 

J^. Orphol or Beta Naphtol Bismuth, Y-z 
drachm. Lard or Vaseline, i ounce. Mix 
well and rub in well morning and evening. 

IJ. Sulphur Praecipitate, i to 2 drachms. 
Lard or Vaseline, i ounce. Mix and rub in 
well morning and evening. 

The patient should have a hot bath, with 
soap and the ointment applied thoroughly. 
Rub in the ointment well morning and even- 
ing. Do not change the clothing or take a 
bath for a week. At the end of a week take 
a good bath, and if the disease is not cured 
repeat the treatment. When the mites are all 
dead the disease is cured. 



INFLUENZA OR GRIPPE. 

Influenza is an acute infectious disease, 
characterized by catarrh of the respiratory 
organs, pain in the head, back and limbs, 
catarrh of the stomach and bowels and by 
extreme prostration. The disease often ap- 
pears in epidemics. Influenza does not often 
kill of itself, but accompanying other dis- 
eases it proves itself to be very serious and 
often fatal. The disease may attack the 
respiratory organs, causing sneezing, water- 
ing of the eyes and nose, hoarseness and 
cough. If the muscles and limbs are at- 



80 MEDICAI, HANDBOOK. 

tacked there will be pain in the back of the 
head and pain in the back and limbs, causing 
intense discomfort and prostration. The di- 
gestive tract is often the center of the trou- 
ble. If this be true there will be colicky pain 
in the stomach and bowels. Nausea and loss 
of appetite. Indigestion after eating and 
colicky pains. Diarrhoea will also be a com- 
mon symptom. 

The grippe usually begins in an abrupt man- 
ner, with languor, pain in the head and back 
and slight fever. Soon the respiratory 
organs, the stomach and bowels or the nerves, 
muscles or joints may one or all become much 
affected. Complications with lung diseases, 
kidney affections and intestinal disorders are 
all to be regarded as unfavorable and are to 
receive what care they may demand. 

Treatment. — There is no specific for the 
grippe or influenza. Rest in bed is to be en- 
forced. Hot water bottles to the aching 
localities will afford some relief. The food 
should be liquid and such as may easily be 
digested. Milk, eggnog and beef tea are all 
of much service. Keep up 'the strength of 
the patient. 

Such remedies as Aconite, Gfelsemium, 
Belladonna and Ipecac may be given as the 
stage of the disease or symptoms may de- 
mand. Stimulants or tonics are beneficial. 



JAUNDICE. 

Jaundice, or yellow coloring of the skin, 
is not a disease of itself, but a symptom of 
some deeper acting condition. 

Before ever the skin becomes yellowed the 
coloring is to be seen in the eye. 

The cause is generally an obstructive one, 
to the outlet of the bile from the liver. 
Biliary calculi may become clogged in the 
common bile duct, and be the cause of the 
jaundiced condition, for if the bile cannot be 
thrown off it will be absorbed and carried 
over the system by the blood and deposited 
in the tissues. The skin and eyes give evi- 
dence of the saturation of the body wjith 
bile. 

Catarrhal conditions of the stomach and 
small intestines may be considered by far 
the most common cause of jaundice. The 
catarrh extending up the common bile duct 
obstructs the flow of bile and the same train 
of symptoms is produced as when a calculi 
occludes the passage of the bile. There is 
generally constipation, and the movements 
are attended with much straining and the 
passage of a clay colored stool and mucus. 
The skin is dry and scaly. The urine high 
colored and froths on being passed into a 
recepticle. 

6 



82 MKDICAI, HANDBOOK. 

Treatment. — Since there is obstruction to 
the flow of bile it is quite reasonable to re- 
frain from eating food that will excite the 
liver to action and require the action of the 
bile to be digested. Sugars, fats and starches 
should be avoided, and the patient put on 
lean meat, eggs, toasts and tea or milk. If 
constipation be present a dose of castor oil 
should be given and the bowels be kept open. 
Small doses of Bismuth Subnitrate, given 
two hours after meals, are often of service. 
From I to 3 drops of the Tr. Nux vomica 
after meals, is also a good tonic. When the 
inflammation subsides the bile will escape 
and the jaundice disappear. 



PREGNANCY. 

Normal pregnancy lasts 280 days, 40 weeks 
or a little more than 9 calendar months. 
Quickening occurs about the 16 or 18th week. 

The signs of pregnancy are the absence of 
the flow, darkening of the zone around the 
nipple, bluish discoloration of the genital 
mucous membrane, enlargement and finally 
quickening. 

It is important that the health of the moth- 
er be sustained from the very incipiency of 
pregnancy. The clothing should be warm 



PREGNANCY. 83 

and free about the waist and abdomen. Lac- 
ing to hide the increasing tumor is a bad 
practice. The food should be such as is easily 
digested. All the products of the frying pan 
and rich pastries are objectionable. There 
is a tendency in the later months of preg- 
nancy to constipation, which should be com- 
bated by eating fruits, prunes being one of 
the best. Oat mush is also a good diet. 
Enemata may be required to keep the bowel 
properly emptied. Daily exercise in the open 
air is highly advisable. Hot and over-crowd- 
ed places should be avoided. 

MORNING SICKNESS. 

There is no regularity in the degree or 
frequency of morning sickness. The cause 
is doubtless reflex nervous phenomena from 
the gravid uterus. When the uterus rises out 
of the abdominal cavity, and has more room, 
the morning sickness becomes less severe. 
The patient should not be allowed to miss 
the breakfast, and, if from rising sickness oc- 
curs, it is best to give a cup of coffee made 
after the directions in this book and some 
light food, and later in the forenoon she may 
get out of bed. 

FALLING. 

About the end of the thirty-ninth week the 
breathing becomes more free and the appe- 



84 MEDICAI, HANDBOOK. 

tite is better, though frequent urination may 
disturb the rest of the patient and constipa- 
tion be quite marked- This condition pre- 
cedes labor about a week. If there is a varia- 
tion it is less and not more than a week until 
labor. 

MISCARRIAGE. 

Pregnancy may be interrupted at any stage 
or date of gestation. Before the end of the 
third month such interruption is called a mis- 
carriage. The symptoms are little more than 
a severe prolonged menstruation. Miscar- 
riage is apt to occur at either the eighth or 
twelfth week of gestation. The patient should 
go to bed when miscarriage is threatened and 
there is pain in the back and abdomen. Mis- 
carriage should be prevented if possible by 
quiet and by rest during the eighth and 
twelfth week, for when once the habit of 
miscarriage is established there may be much 
trouble to advance pregnancy beyond that 
date. It is better for the mother to go on 
to full term than to suffer miscarriage or 
abortion. 

ABORTION. 

After the third month, and before the 
seventh month, if . the uterus spontaneously 
empties itself the condition is termed abor- 
tion. Abortion is a more grave condition to 



PREGNANCY. 85 

handle than labor. Usually there is a period 
of heaviness in the abdomen and pain in the 
back preceding the expulsion of the ovum. 
If abortion is threatened the mother should 
be put to bed and the bowels moved by an 
enema, for often disturbances of the intes- 
tines produce irritation of the uterus. A mild 
purge may be given, such as 1 / 10 grain 
of Calomel hourly, for 5 to 6 doses. The 
same cleanliness required to be observed in 
labor is indicated in the care of abortion. 

Rest in bed is strongly to be enjoined. Do 
not encourage the uterine pains in any way, 
for nature wishes time to render the separa- 
tion of the placenta less dangerous. Rapid 
delivery of abortion cases is very apt to be 
attended with profuse bleeding. 

In abortion cases the breasts may make 
some trouble. If enlarged they should be 
bandaged firmly and internally, 1 / roo grain of 
Atropine may be given for 4 to 5 doses six 
hours apart. 

LABOR. 

The infant becomes viable after the seventh 
month, and the delivery after that date is 
called premature labor until at full term, 
when the denomination of premature labor 
is superfluous. 

Labor at the seventh or eighth month is 
less desirable than at full term, but the con- 



86 MKDICAL. HANDBOOK. 

ditions and procedures are the same as at 
full term, only there is more danger that the 
placenta will make trouble by being slow of 
delivery than at full term. 

When labor is expected it is well to move 
the bowels and empty the bladder that these 
organs do not obstruct the passage of the 
child. There may be a discharge of bloody 
mucus called a show, which is very suggestive 
of oncoming labor. 

True labor pains generally begin in the 
back and extend around the abdomen. 

FIRST STAGE OF LABOR. 

While the uterus is being dilated and the 
pains are severe, but not of a bearing down 
character, the period of time thus consumed 
is termed the first stage of labor. The time 
required to dilate the opening of the womb 
varies greatly. From a very short while to 
6 or 8 hours or even more. The pains are 
at first cramp-like and not very frequent. 
Later they become more frequent and more 
intense. The patient need not be put to bed 
during this stage, and may with much benefit 
take hot sitz baths. Allow the woman to 
walk around the room and to sit in a tub of 
hot water when she likes. The hot water is 
soothing and tends to relax the outlet, mak- 
ing the second stage of labor easier. Hot 
milk and beef tea may be given to keep up 



PREGNANCY. 87 

the woman's strength. When the membranes 
rupture and the waters come away or the 
pains assume a bearing down character it is 
time for the patient to go to bed. 

SECOND STAGE OF LABOR. 

From the time the pains assume an ex- 
pelling character until the expulsion of the 
infant the labor is said to be in the second 
stage. The position for delivery is prefer- 
ably on the left side, with the buttox near 
the edge of the bed. It is not necessary for 
the woman to lie on the left side during the 
second stage of labor, but to turn on the left 
side before delivery. 

If the second stage is protracted and the 
pains seem to have little effect remember that 
in two ways this is the best. First, the out- 
let is given time to dilate and tearing is not 
near so apt to occur, and, second, the con- 
dition of the uterus will be better for the 
prompt expulsion of the placenta in the last 
stage of labor. 

An assistant may place one hand on the 
abdomen and another hand on the small of 
the back. and materially assist and relieve the 
efforts of the mother. The mother will often 
do better if she may hold some one's hands 
or have something to pull on. 

The second stage of labor is usually much 
shorter than the first. When the pains are 



88 MEDICAL HANDBOOK. 

producing the final results and the uterus is 
contracting after the child the hand of an as- 
sistant should follow and hold the uterus 
until the placenta is delivered. 

THIRD STAGE OF LABOR. 

Following the expulsion of the infant there 
is apt to be a short period of rest for the 
mother, and she may sleep. The hand of 
the assistant must not lose the uterus dur- 
ing this time, and if there is any tendency for 
the womb to get large the hand should knead 
or rub the uterus through the abdominal walls, 
and if this does not suffice to produce a con- 
traction of the womb cold water may be ap- 
plied with the hand to the abdomen while 
kneading is continued. The third stage lasts 
until the placenta is delivered, but the hold- 
ing of the womb through the abdomen and 
the kneading to keep the uterus hard is not 
to cease until an hour has elapsed after labor. 
This precaution to prevent flooding should 
not be neglected under any circumstances or 
in no case. 

When the placenta is delivered some one 
should grasp it gently and roll the mass over 
and over, and by gentle traction withdraw 
the membranes. Use no force, for if the 
membranes are broken and remain they may 
cause after pains or become offensive and 
most objectionable. 



PREGNANCY. 89 

FLOODING. 

Should the expulsion of much blood and 
rapid sinking of the patient occur give a hot 
injection of boiled water; give as hot as can 
be borne and not burn the mother. Powdered 
Alum may be added to the water, 1 teaspoon- 
ful to the pint. Hot compresses may be ap- 
plied to the abdomen. Do not burn, but 
make them as hot as can be borne. Keep 
on kneading the uterus. Smelling salts and 
brandy may be given the mother. Flooding 
is not the rule and an accident that will sel- 
dom occur if the uterus has been watched and 
kneading after the expulsion of the placenta. 

THE CHILD. 

There should be some saturated Boracic 
Acid solution ready to wash the eyes and 
mouth and nose with. The eye should be 
washed out lest some of the discharges of 
the genital canal may have entered the eye 
and set up sore eyes that may be very hard 
to treat. The mouth and nose may be 
cleansed with gauze from the same solution, 
but the solution is immaterial. Simply wash 
the eyes first and then with the same or 
another sponge cleanse the nose and mouth. 

The child should be placed on the right 
side as soon as born, and for the first few 
days following birth, that the heart may be 



90 MKDICAI, HANDBOOK. 

given a chance to become strong. Always 
follow this rule, for the child's heart at birth 
undergoes changes which this position will 
assist. The severing of the cord should be 
done as soon as the cord ceases to pulsate. 
Tie the cord about I inch from the abdomen. 
Tie firmly with a small bit of braid, and be 
sure that no bleeding occurs, for the life of 
the infant may be endangered by a bleeding 
cord. The cord should be tied also on the 
mother's end, lest bleeding from that end 
endanger the life of a possible twin. Never 
fail to tie firmly, and tie twice before cut- 
ting the cord. 

There is no rush about the bathing of 
the infant. A little oil applied will later 
make the bath the more easy. The child has 
come to a colder clime than what he is ac- 
customed to, and it should not be bathed at 
once, for there is already a tendency to a re- 
duced temperature from without. A little 
time for the supply of warmth from within 
is advisable. 

The child may rest as well as the mother 
for several hours before there is any need 
of nursing. Unless there is a tendency for 
the womb to relax then the nursing of the 
child is to be advised, for that act is apt to 
produce contraction of the womb, and aid, if 
needed, in the keeping of the womb small 
until all danger of flooding is over. 



PREGNANCY. 91 

Dress the cord with some absorbent cotton 
and Boracic Acid dusting powder. 

LYING-IN PERIOD. 

During the first three days the mother 
should not be fed on heavy foods or given 
much tea to drink, lest the digestion be dis- 
turbed or the milk come too soon and too much 
for the child. 

A binder is customary among some people, 
but the good done is very limited indeed. 

On the third day there is apt to be a rise 
of temperature at the time of the filling of 
the breasts with milk, but this temperature 
does not last long and is soon back to normal. 

If the bowels have not moved by the third 
day give 1 / 10 grain doses of Calomel for 6 
or 8 doses and an enema if necessary. 

The mother should be bathed daily, but do 
not expose so as to catch a cold. The posi- 
tion of the mother is not important. On the 
back or side, as she may desire. One con- 
tinual position is apt to be followed by a 
sagging of the womb to that side, and so 
the position should be changed from the 
back to either side. There may be an extra 
pillow allowed by the end of the third day. 
but the patient is not to sit up or get out of 
bed until the uterus can no longer be felt 
back of the pubic bone. There is a rule to 
get up on the ninth day, which rule is 



92 MEDICAI, HANDBOOK. 

erroneous ; no patient should get up until the 
womb is back to what it was before preg- 
nancy. It is safe not to get up before the 
ninth day, but many should remain in bed 
longer. 

The flow, which is at first bloody, later be- 
comes more clear and finally ceases about the 
ninth or tenth day, but usually lasts a little 
longer if the person is on the feet. 

After the fifth day the danger of child- 
bed fever is much lessened, and practically 
over by the end of the first week. 

When the mother is delivered there is in 
the uterus no covering membrane and the 
womb is as a large surface anywhere with- 
out a covering to protect it. Infection may 
occur as of any wound, but the infection 
must come as in other wounds, for the most 
part from without. For this reason meddle- 
some mid wives' fingers in the genital tract 
during labor or the use of some unsterile 
household syringe may prove not only useless, 
but absolutely dangerous. 

No one coming from a house where ery- 
sipelas, scarlet fever or any of the infectious 
diseases are existing should be admitted to 
the lying-in chamber. Should the tempera- 
ture go up, the pulse become rapid and the 
abdomen tender during the first week of the 
lying-in period you would be justified in 
thinking the womb was infected. It is then 



PREGNANCY. 93 

necessary to give one or repeated hot vaginal 
injections. Boracic Acid may be used in a 
saturated solution, or, if the case be urgent, 
the Bichloride of Mercury i to 5,000 may be 
employed. The patient's head may be elevat- 
ed in order to increase the drainage from the 
womb. 

Aconite may be given, 0, 1 tablet every two 
hours. 

Quinine and whisky or brandy should be 
given freely if needed as a tonic. 

If the Bichloride of Mercury injection is 
used, do not use too frequently, but between 
times use the Boracic Acid solution. 

Be careful that the syringe and hands and 
all else are sterile, as you should have been 
during the whole course of the lying-in 
period, lest more infection be introduced. 
The syringe and its nozzle should be always 
a sterile one, rendered so by boiling or anti- 
septics. 

Always call a physician if possible where 
there is danger in the lying-in period. 



MUMPS. 

Mumps usually appears in epidemics. It 
is an acute infectious disease, involving the 
glands of the cheek and the glands below the 
tongue. Children are more frequently af- 
fected than adults, but no age or sex is 
immune until once they have had the dis- 
ease, after which, if both cheeks have been 
attacked, there is little danger of subsequent 
attacks. After exposure there elapses from 
one to two weeks before the disease de- 
velops. The duration of mumps varies from 
five to seven days. The disease begins with 
chilliness, languor and moderate fever. The 
swelling of the parotid gland is seen below 
and in front of the ear. The tissues sur- 
rounding the gland are also swollen and the 
cheek has a doughy feel. The glands below 
the tongue are swollen and the action of 
the lower jaw is made difficult and painful. 
There may be an excess of saliva or the 
amount may be diminished. Sweet things 
or pickles or anything that will excite the 
activity of the salivary glands causes pain. 
The swelling and all the symptoms usually 
disappear on the fifth day, or they may dis- 
appear from face and reappear in the tes- 
ticle of the male or the mamma in the 
female, or the disease may go to the ovaries 
of the female. 



MEASLES. 95 

Treatment. — There is nothing to be done 
that will cure mumps. It is best to remain 
indoors and avoid exposure to drafts. The 
taking of a cold or exposure may cause the 
metastasis of the disease, to the testicle, the 
mamma or the ovary. Should the mamma 
or testicle become swollen and painful it is 
best to bandage and support them in some 
warm covering. Lead water and Laudanum 
may be used as a hot, wet dressing to relieve 
the pain. Should a high fever complicate 
mumps treat the fever as any other fever. 



MEASLES. 

Measles is a disease of an acute contagious 
nature. Has been known for centuries. 
Children are most apt to have measles, but 
neither age nor sex renders a person im- 
mune. One attack usually prevents a sec- 
ond occurrence of the disease, but does not 
always render the individual immune. The 
disease is characterized by watering of the 
eye, dread of light, running of the nose, 
cough and a papular eruption and slight des- 
quamation or scaling. 

Measles are highly contagious. The period 
of incubation is about two weeks, usually a 
few days less, but there may be a few days 



96 MEDICAI, HANDBOOK. 

more than two weeks elapse before the dis- 
ease develops. 

The first symptoms are watering of the eye, 
running of the nose and much irritation of 
the upper air passages, resulting in cough. 
During the first twenty-four hours the tem- 
perature rises to a little over 100 F. If the 
temperature is very high at the end of the 
first day the attack will probably be a severe 
one. If the temperature is only moderate the 
disease may not be severe. After the first 
rise in temperature, or on the second day, the 
fever may go down to near normal and the 
child seem better and have a better appetite, 
but the cough and running of the nose and 
watering of the eyes increase until about the 
end of the third day or the beginning of the 
fourth day, when the temperature rapidly 
goes up again and the eruption appears on 
the face. The eruption appears as an efflor- 
escence or reddened patches or papules of 
irregular shape. The eruption extends to 
the neck and chest, and thence all over the 
body, being fully developed in about thirty- 
six hours. On the face the eruption is the 
most marked, and it is not uncommon to 
have the eyes swollen and partially closed. 
While the eruption is appearing all the symp- 
toms are apt to be increased. 

The watering of the eyes and dread of light 
is worse, the running of the nose and cough 



MKASIvKS. 97 

is more pronounced, and the temperature is 
higher than in the beginning of the disease. 
There may be disturbances of digestion, with 
nausea and vomiting, and also there is often 
a diarrhoea of frequent watery movements. 

The eruption becomes fully developed and 
all the other symptoms reach their height in a 
few days, the temperature rapidly falls and all 
of the symptoms improve, and the epithelium 
is cast off in fine flakes, beginning first on 
the face and extending over the body in the 
same order as the eruption appeared. 

The complications of measles are of much 
importance. There is a tendency to lung trou- 
bles after measles and much care should be 
observed lest colds be contracted, which may 
result in persistent bronchitis or even pneu- 
monia. There seems to be a peculiar weak- 
ness of the lungs after measles, making 
tubercular or consumptive infection very 
easy. Very persistent middle ear disease 
may also develop and the child should be 
guarded from exposure for some time. 

Treatment. — The patient should be isolat- 
ed to prevent exposing others. Liquid diet 
or easily . digested food should be given. 
Medicines are of little service, and are only 
to be administered where there are some 
particular symptoms requiring relief. The 
choice of remedies must depend on the con- 
dition calling for drugs. When desquama- 



98 MKDICAI, HANDBOOK. 

tion begins it is often soothing to oil the sur- 
face of the body with some simple oil. 



SORE MOUTH. 

Sore mouth may be due to injury to the 
membranes of the mouth or to the presence 
of bacteria that cause ulcers in the mouth. 
The symptoms of sore mouth in general are 
heat and pain in the mouth and an increase 
in the flow of saliva. The breath may smell 
and the child be languid and refuse to nurse, 
and in severe forms fever may be present. 

1. The simple form of this affection is char- 
acterized by redness of the mouth, and is 
usually due to a burn or some irritant taken 
into the mouth. Cleanness is all that is re- 
quired for its treatment. 

2. The second form of sore mouth, called 
aphthous stomatitis, is characterized by small 
blisters over the tongue, lips and cheeks. 
These little blisters soon break and form 
ulcers. 

The treatment is simply cleanliness by wash- 
ing out the mouth with the following solution : 

1^. Chlorate of potash, 20 grains. Gly- 
cerine, one-half ounce. Water, one and one- 
half ounces. Mix. 

With a piece of cotton or gauze saturated in 



SORE MOUTH. 99 

the above solution wash out the mouth. As 
indigestion figures in the cause of this affec- 
tion, feed the child at regular intervals, and 
thoroughly empty the bowels by a dose of 
Castor oil. 

3. Parasitic form from sore mouth or 
thrush. This form of sore mouth is due to a 
specific fungus, and on inspection may be seen 
elevated patches, which, when removed, leave 
the raw surface ; the patches are found on 
the tongue and cheeks, and may spread over 
the entire mouth, and into the throat. There 
is much soreness of the mouth. The saliva 
runs from the mouth, and eating is attended 
by pain. 

Treatment. — Cleanse the mouth (Several 
times a day, and by applying a pledget of cot- 
ton to each spot or ulcer the following solu- 
tion : 

1^. Borax, one dram. Glycerine, two 
ounces. Water, six ounces. Mix. 



t 



G. 



MENSTRUATION AND THE DIS- 
ORDERS OF MENSTRUATION. 

MENSTRUATION. 

Normal menstruation is a periodical dis- 
charge of blood from the uterine cavity, re- 
curring at regular intervals. 

In the majority of cases the period begins 
every twenty-eight days. A few vary from 
this rule a day, more or less, but if the period 
is regular on the twenty-sixth or thirtieth day 
there is no deviation from health. Menstrua- 
tion begins at puberty or about the twelfth 
year of life, and continues until the meno- 
pause, or about the forty-fifth year of age. 
A cold climate tends to delay the appearance 
of the flow, which may not appear before the 
sixteenth year. 

The symptoms of normal menstruation are 
more objective than subjective, though few 
women escape a full, heavy feeling in the 
pelvic organs previous to the advent of the 
flow. 

The normal period continues from two to 
eight days, and the quantity of blood lost 
varies from two to nine ounces. The average 
period is about four days, and the quantity 
of blood lost about five ounces. Unless there 
is a profuse flow there is no clotting. 



MENSTRUATION. IOI 

Young girls should be forewarned by their 
mothers as to the appearance of the menses, 
as they may be very much alarmed and re- 
sort to rash measures to stop the supposed 
haemorrhage; or the scare may result in the 
disappearance of the flow, or derangement of 
what should become a regular function. 
When girls and boys arrive at puberty they 
should be counseled as to the advent of natural 
functions and passions, which, if normal and 
kept in proper limits, insure the physical and 
mental and the moral development of a man or 
woman, while on the other hand, if the sexual 
hygiene be neglected, health and happiness 
may be sacrificed. 

AMENORRHEA, OR WANT OF FLOW. 

The flow may not appear at puberty, caused 
by a poorly nourished condition of the sys- 
tem. At times the flow may be absent because 
of obstruction to the outlet. When the flow 
is absent as a result of an impoverished con- 
dition of the system, the blood will be greatly 
lacking in the red blood corpuscles, and the 
patient will have a waxy, greenish, white 
complexion. There are frequent outbursts of 
nervousness and hysteria. Mental and physi- 
cal effort are followed by physical prostration. 
There will be a desire for sour foods, such as 
pickles and vinegar, and at time for the 
earthy substances, such as chalk or charcoal, 



102 MEDICAI, HANDBOOK. 

while meats will be rejected. The heart is 
poorly nourished. The pulse is weak, and 
running up stairs or climbing a hill causes 
palpitation and faintness. Emotions will also 
cause palpitation. Headache is common, 
worse from motion. Pain around the heart is 
not uncommon. Instead of the flow there 
may be only a watery discharge, and in some 
cases there is a watery discharge almost all 
the time. 

Treatment. — Improve the general health by 
giving plenty of fresh air and sufficient ex- 
ercise; but do not exhaust the patient. 

Tonics are often beneficial, such as 

R. Nux vomica, three drops, three times a 
day. 

]^. Potassium iodide, three grains, well 
diluted in water, three times a day. 

R. Blaud's Iron Pills, one twice a day. 

Locally, warm sitz baths with enough 
brown mustard in the water to make the skin 
red are very helpful. 

The hot douche is the most reliable help. 
Use two quarts of hot water (no° F.). Have 
the patient lie on the back and flex the legs ; 
retain the hot water as much and as long as 
possible. Such a douche should last for a half 
hour. Keep the water hot. 

Amenorrhcea may be due to exposure, to 
cold and wet just before the courses should 
appear. Sometimes fear or sorrow will pre- 



MENSTRUATION. I03 

vent the appearance of the flow. Pregnancy is 
usually associated with a non-appearance of 
the flow. But in health some even menstruate 
when pregnant, (such cases are not the rule). 
Change of climate, as a long sea voyage, may 
cause the disappearance of the flow for a few 
months. Serious depleting diseases are fol- 
lowed by absence of the flow. It is evident 
that when the system is run down and the 
blood is poor and scant that the flow would be 
an added drain to the system. In such cases 
do not try to bring on the flow, but improve 
the health and blood with tonics. 

Where from fear, exposure or accident the 
flow has not appeared or has stopped too soon, 
the hot sitz bath, the douche, and the internal 
use of Actea racemosa, Pulsatilla or Sepia 
should be tried. 

DYSMENORRHEA, OR PAINFUL MENSTRUATION. 

This term implies menstruation that is per- 
formed with difficulty. Pain is a troublesome 
symptom of such patients. The cause of dis- 
menorrhcea may be misplacements of the 
uterus, an imperfect outlet, and as a natural 
result of age on a uterus that has never suffer- 
ed any other changes than menstruation such 
is often the case in maiden ladies of advanced 
years. 

The treatment is to remove the cause, which 
is usually a natural or mechanical one. Medi- 



104 MEDICAL HANDBOOK. 

cal assistance may help, and the drugs that 
should be thought of would be Actea race- 
mosa, Sepia and Asafcetida. Hot sitz baths 
may be beneficial. This as well as many other 
female complaints often finds permanent relief 
after pregnancy. As not all cases are subject 
to the same causes it is well to place such 
cases in the hands of competent medical at- 
tendants. 

MENOPAUSE, OR CHANGE OF LIFE. 

The sensation of the menses is as important 
as the establishment of the function, and as 
much care and consideration is as necessary 
as in early life when the catamenia began. 

For a period of about thirty or thirty-three 
years the pelvis has been subject to repeated 
engorgement and nervous centralization, and 
when change of life comes there is a call for 
a change of outlet for the local activity of the 
circulation and nerves. The symptoms of this 
period of change in a woman's life are very 
marked and greatly varied. There is scarcely 
a limit to the symptoms that may arise at this 
time, and the patient should be prepared for 
many things that in young womanhood do not 
occur. The courses become irregular in period 
as well as in amount. Flushes of heat to the 
head and face or to different parts of the 
body are common. Headache, vertigo, dis- 
turbances of digestion and haemorrhages from 



MENSTRUATION. I05 

the uterus and nose are common. Mental de- 
pression, loss of memory and loss of power of 
attention are also common symptoms. The 
period of change and disturbed nervous and 
functional symptoms caused by the cessation 
of sexual life last for a period of from one to 
two years ; but the most marked symptoms oc- 
cur during a period of about six months in the 
middle of this time. 

There is no need of alarm when this period 
is reached. The haemorrhage or loss of blood 
from the uterus or the nose-bleed that may 
occur, and at times bleeding from the rectum, 
all give relief to nature, and the habit that for 
so long a period has existed, and are more 
beneficial than detrimental, unless too severe 
or too prolonged. The care of an experienced 
physician is to be desired and secured, if pos- 
sible. If the change is passed successfully the 
lease on life is extended indefinitely. 

Treatment. — While the nerves and circula- 
tion are struggling with a habit that for years 
has affected the system so profoundly, and a 
state of uncertainty seems to prevail, it is but 
logical that the best of hygienic methods of 
life should be observed. Keep the skin active 
by frequent bathing and rubbing with a rough 
towel. Avoid excitement! or over physical 
strain. Sleep should be encouraged. A warm 
bath before retiring is a very good way to pro- 
mote sleep. Regulate the diet to wholesome 



106 MEDICAI, HANDBOOK. 

easily digested food. Do not be afraid of 
fresh air and sunshine. 

Avoid all alcoholic stimulants. Do not re- 
sort to nerve sedative medication, as it often 
does more harm than good, and may result in 
a drug habit, fastening itself on the patient. 
Candies and pastries are to be eaten in 
moderation. 

Sepia, Actea racemosa, Pulsatilla, Asafoetida 
and other remedies named in this treatise 
should be studied as possible remedies for 
some of the nervous and physical phenomena. 



NEURALGIA. 

Pain radiating along the course of a nerve 
trunk is called neuralgia. The causes are 
numerous. Nervous temperament and hered- 
ity, overwork and general exhaustion are pre- 
disposing to neuralgia. 

Rheumatism, gout, lead poison and disease 
of the nerve trunks or nerve ganglia are per- 
sistent causes. Exposure to sudden changes 
of temperature often excite an attack. 

Depression of spirits and tingling in the part 
affected often precede an attack. Sharp stab- 
bing pain in the part with tenderness along 
the course of the nerves are always prominent 
symptoms. The attack may last from a few 
hours to a few days. 



NKURAIvGIA. 107 

Following an attack of neuralgia there is apt 
to be profuse urination of clear or pale urine. 

Neuralgia of the nerves of the face is very 
common, and may be caused by decaying teeth, 
or disease of the nerves, or of the ganglia 
from which the nerve springs. 

Intercostal neuralgia is a common affection 
of the chest. Has a tender spot near the spinal 
colunmn where the nerve is given off, and a 
line of tenderness under the rib along which 
the nerve lies. Sciatica is but a form of 
neuralgia, and has for the prominent symp- 
tom pain along the course of the sciatic nerve. 

Ttreatment. — The treatment of neuralgia 
will of necessity be directed to the cause. 
Locally, much relief may follow the use of hot 
applications, and liniments that have an irri- 
tant action to the skin. Tr. aconite and Tr. 
arnica may be used in equal parts and painted 
along the course of the painful nerve. Tr. 
iodine may be used as an application to the 
painful area. Belladonna plasters at times 
afford relief. Avoid opiates, as there is the 
greatest danger of forming the opium habit 



NOSE-BLEED. 

Nose-bleed may be caused by injury, and by 
obstruction of the circulation such as chronic 
heart and lung disease. Certain affections of 
the blood and the onset of some of the fevers 
have nose-bleed as a symptom. In crossing 
mountains where the atmosphere is light 
nose-bleed occurs. At times without any ap- 
parent cause bleeding may develop. When 
nose-bleed is associated with a blow or in- 
jury to the head it may be an indication of 
fracture of the skull, if the nose was not in- 
jured by the blow. 

Treatment. — Apply ice cold water to the 
back of the neck and to the nose. Snuffing 
up into the nose alum solution, of one drachm 
of alum to four ounces of water, is very effect- 
ual where there has been direct injury to the 
nose, or a pledget of cotton saturated in this 
solution may be applied or packed closely into 
the bleeding nostrils. 

Adrenalin, Chlorid, used as a spray, is often 
very effectual. 

At times nothing will stop the flow of blood 
from the nose except careful packing of the 
nasal passage with gauze or cotton. 

Association with headache or congestion of 
the head and face, nose-bleed is often bene- 
ficial unless too profuse. 



PALPITATION OF THE HEART. 

Causes. — Palpitation is a symptom of 
organic heart disease, of dyspepsia and the 
result of certain drugs in their action on the 
system. Palpitation is also associated with 
anything that will for the time unbalance the 
nervous equilibrium, such as joy, fear or 
anxiety. Disturbances of the reproductive 
organs often cause palpitation ; this is more 
frequently noticed in girls than among boys. 

Symptoms. — A violent action of the heart 
perceptible to the patient, and noticeable to 
any who may examine the pulse or listen to 
the heart. There is no rule as to frequency of 
the heart beats, as different cases differ in this 
particular. 

Treatment. — If the palpitation is aggravat- 
ed by the use of tobacco, tea or coffee, stop 
their use. If tobacco, tea or coffee disturb the 
harmony of the functions or organs of the 
body, they are drugs to that individual and 
should not be used in health. Where the 
digestion is at fault or the heart diseased, be- 
sides the treatment of these ailments, the fol- 
lowing has been of value: 

1^. Tr. nux vomica, one drop, three times a 
day; give on sugar or tablet; also, I£. Tr. 
aconite, one drop, three times a day, has been 
of service for many nervous cases ; give on 



110 MKDICAI, HANDBOOK. 

sugar or in tablet; also, I£. Asafoetida, three 
grains ; Ext. nux vomica, one-fourth grain 
pill. One in the morning and one in the 
evening. 

This latter prescription is especially of 
value for nervous girls or women. For the 
Eskimo women of Alaska who are troubled 
with the heart symptoms and fainting spells, 
or hysterical seizures, this is probably the 
best medicine to give them, as it quiets the 
nerves and at the same time assists the heart 
and the digestion. 

Pulsatilla in the homoeopathic preparation 
given in the tincture ranks as one of the first 
drugs for girls about the time of puberty who 
are troubled with palpitation. Give one or 
two drops three times a day. There are various 
drugs given according to Homoeopathy for 
this trouble, but to give them in a proper 
manner consult the indications given for the 
drugs. 



PNEUMONIA. 

The lung may become inflamed from a 
variety of causes, but the most common as 
well as most dangerous is that form called 
croupous pneumonia. This form is some- 
times spoken of as the natural end of the old 
man, as so many of the aged die from it. 



PNEUMONIA. Ill 

CROUPOUS PNEUMONIA. 

Croupous pneumonia is an acute specific 
disease, due to a special organism, and is 
characterized by an inflammation of the lungs. 
High fever, cough, "rust" colored sputa, 
shortness of breath and pain on breathing. 

Causes. — A specific organism which thrives 
only when the vitality is lowered by pre-exist- 
ing disease or any strain that reduces the 
general health. Exposure to cold and wet 
frequently brings on the attack. One attack 
predisposes to subsequent attacks. 

PATHOLOGY OR COURSE OF THE DISEASE. 

The disease has three stages. The first stage 
is one of congestion of the lung. The small 
blood vessels called capillaries are distended 
and permit a slight exudate, and the lung is 
hardened. 

In the second stage the hardened lung be- 
comes infiltrated with blood and is of a deep 
red color, and so heavy it sinks in water. 

The third stage is one of resolution by ah- 
sorbtion of the part of the exudate and ex- 
pectoration of the balance, or the lung may 
change from red to gray; that is, the exudate 
changes from blood to pus ; the lung becomes 
inltrated with pus and the patient dies prac- 
tically from blood poisoning. Or early in the 
disease death may be caused by diminished 
air space. 



112 MEJDICAIy HANDBOOK. 

The two extremes of life succumb to this 
disease readily. The consolidation of the dis- 
ease usually begins in the lower lobe of the 
right lung at its base and spreads upwards. 
The pleural membrane and the adjacent bron- 
chial tubes share the inflammation of the 
lung. 

Symptoms. — The disease generally begins 
with a decided chill and a sharp pain in the 
side. The temperature within the next twenty- 
four hours reaches a maximum of 104 or 105 
degrees F., at which point with slight daily re- 
missions it remains until the crisis, which 
usually occurs about the ninth day. The fall 
of the temperature is so rapid that on the 
tenth day it may be normal. In atypical cases 
the temperature may gradually go back to 
normal. Breathing is difficult. The respira- 
tions are shallow and rapid, advancing from 
the normal of 18 per minute, to 40 and even 
60 to a minute. The pulse is raised to 120 per 
minute or more, but not in proportion to the 
breathing. Normally the heart beats 4 times 
to 1 act of respiration, but in pneumonia the 
ratio may be reduced as low as 2 to 1. Cough 
is a prominent symptom, which at first is 
short and dry, but later the sputa has a rusty 
appearance from the blood it contains. The 
sputa may be very tenacious, stringy and ex- 
ceedingly hard to expectorate. The face is 
flushed, the lips dark blue and frequently 



PNEUMONIA. 113 

there are fever blisters on the lips. The 
tongue is furred, the bowels constipated, the 
urine scant and high colored, and when test- 
ed with Nitrate of Silver solution does not 
throw down a white precipitate; this shows a 
lack of the chlorides, and when the precipi- 
tates begin to appear a change for the bet- 
ter is usually at hand. 

Delirium is also a common symptom. Dur- 
ing 'the course of the disease the chief sound 
that can be heard on listening to the chest is 
bronchial breathing or the sound of the air as 
h rushes back and forth in the larger air 
passages. If the patient speaks over the area 
affected the sound is increased and near to 
the ear; later in the disease or in the third 
stage fine, moist rales can be heard. 

In the aged the symptoms of pneumonia are 
not typical. The temperature may not be high 
at first; delirium, however, is common and 
prostration very marked. In children the on- 
set may be marked by convulsions, headache, 
delirium, drowsiness and very high tempera- 
ture. Expectoration is absent at first. 



8 



PLEURISY. 

Stimulates pneumonia, but does not have 
the rusty expectoration. The chill is less 
marked and the temperature not so high and 
the breathing is distant and weak. Severe 
pain in the side is the most marked symptom 
of pleurisy. The fall of temperature is not 
as marked in pleurisy as in pneumonia. The 
prognosis of pneumonia is grave at either ex- 
treme of life. In the young and strong the 
prognosis is usually good. The average ratio 
of death is one case out of five. 

Treatment. — Absolute rest in bed. The 
diet should be liquid and such articles as 
eggs and milk or broth of meat or game may 
be given. The chest should be enveloped in 
some warm material. The disease is self- 
limiting and runs a course that no remedy 
can cut short. The object would be to sus- 
tain the strength of the patient until the dis- 
ease has had time to run its course. When 
the crisis of the disease comes the tempera- 
ture falls at once and the patient should be 
watched well lest the fall in temperature be 
so great as to cause the patient to die from 
the exhaustion at this most critical time. At 
about 2 o'clock in the morning there is a 
natural fall of temperature, and should the 
crisis occur at this hour the danger is in- 



PLEURISY. 115 

creased. During the course of the disease 
there may be need of Alcoholic stimulation, 
but at the time of the crisis there is a great 
probability that stimulation will be called for, 
especially if the fall in temperature occurs 
early in the morning. Should the temperature 
fall at any time, and it will surely fall about 
the ninth day, and collapse seem near, there 
is urgent need of Alcoholic stimulation. 

During the disease constipation should be 
overcome by mild cathartics or by ensemata. 

Baths if given must be performed under a 
blanket and every care and caution taken not 
to expose the patient lest a cold be taken. 

While pneumonia is regarded as not con- 
tagious it is by far the safer policy not to 
allow those suffering from a cold on the chest 
to spend too much time in the room. The 
sputa, of course, should be burned or properly 
disposed of. The germs are in the sputa and 
perhaps in the air, and undue exposure of 
those suffering with a cold or bronchitis is to 
be guarded against. 



RING WORM. 

Ring worm is caused by a vegetable para- 
site affecting the skin. Ring worm may de- 
velop on the scalp, face or any part of the 
body. The disease may be transmitted from 
man to man or from the lower animals to man. 

The disease begins with one or more round- 
ed elevated gray scaly patches, through the 
center of which project dry, brittle or broken 
hairs. The center may heal, but on the margin 
the disease spreads in a rounded or circular 
manner. 

Eczema may resemble ring worm, but the 
hair is not broken off, nor are the scales 
round. Eczema does not heal in the center 
and spread on the edges, and eczema has in- 
tense itching, while ring worm has not. 

Treatment. — Remove all scales. Pull out 
the hair on the face or body, or if on the 
scalp shave the affected area. Rub in well 
twice a day one of the following ointments : 

]^. Acid Salicylic, 30 grains. Sulphur 
Prsecip., 1 drachm. Vaseline, 1 ounce. Mix 
well and rub in well twice daily. 

1^. Ammoniated Mercury, 20 grains. 
Vaseline, 1 ounce. Mix well and rub in 
twice a day. 

f$. Blue Ointment. Rub in well twice a 
day. 



RICKETS. 117 

The parasite of ring worm lives at the root 
of the hairs and the disease is sure to last 
until the germs are all destroyed. 



RICKETS. 

Rickets or rachitis is a disease of early 
childhood, and is characterized by poor nutri- 
tion and defective development of the bony 
structures of the body. The symptoms arc 
restlessness and fever at night, tenderness and 
soreness of the body and especially is there 
soreness and tenderness about the joints. 
Profuse perspiration about the head. The 
fontanelles or natural unclosed parts of the 
skull are long in closing. The teeth slow In 
coming, and the teeth may be unnaturally 
formed. There is apt to be knock-knees or 
bow-legs. There may be curvature of the 
spine. The chest is apt to be distorted and the 
condition known as chicken-breasted often 
exists. 

This diseased condition is due to improper 
nutrition and a lack of the lime salts. 

Treatment. — The health of the child must 
be improved and the digestion encouraged 
Eggs, milk and meat should be given freely 
in sufficient quantities. Fresh air and sunshine 
are two very advisable additions to good 
feeding. 



Il8 MEDICAL HANDBOOK. 

There is much good derived from the ad- 
ministration of tonics. Calcarea carbonica is a 
very good remedy, and will do much for such 
patients. Lime water as is ordinarily secured 
from the drug store may be given with the 
milk. 



RHEUMATISM. 

Acute articular rheumatism is an acute dis- 
ease of the system and is characterized by a 
fever that is not regular, inflammation of the 
joints and acid perspiration. The heart may 
be involved and chronic heart disease result 
from rheumatism. 

The cause is probably an impurity in the 
blood. The decomposition and removal of 
waste matter from the body may be impair- 
ed and the substances absorbed by the blood 
act as the exciting cause. There seems to 
be less likelihood of the germ theory being 
applied to rheumatism as a cause of the symp- 
toms than to other affections, but even this 
may be true. 

The symptoms may follow a spell of chilli- 
ness, languor and sore throat, or appear 
abruptly, with swelling of any of the joints 
and intense pain. The knee, shoulder, elbow 
and wrists are most frequently attacked. The 
pain may disappear in one joint and reappear 



RHEUMATISM. II9 

in another. There is apt to be moderate fever 
and at times very high fever may complicate 
the disease. The sweating is often profuse 
and of a sour odor. The tongue is coated and 
the appetite lost, and the bowels constipated. 
The urine high colored and throws down an 
abundant sediment. 

Treatment. — Rest is of first importance in 
treating rheumatism. Cover the affected part 
with a woollen dressing. Allow plenty of fresh 
air in the room, but do not expose the patient 
to a draft. Liquid diet is preferable to the 
heavier foods. Encourage digestion, avoid 
meats, and pastries. 

Lithia tablets or drinks are of value. Sali- 
cylate of Sodium, in 10 grain doses, three 
times a day, will often reduce the pain. Ap- 
plications of hot water with a little oil of 
gaultheria or oil of turpentine may be applied. 
Lead water and Laudanum may relieve if 
used locally. 

There is often a painful affection of the 
muscles, and known as muscular rheumatism. 
Exposure to wet and cold is usually the direct 
cause. Those with a rheumatic tendency are 
apt to have muscular rheumatism. Muscular 
rheumatism may affect the neck and produce 
twisting of the head to one side ; there will be 
much pain in the muscles of the neck on mo- 
tion. Rheumatism of the muscles of the back 
is usually called lumbago, and is greatly ag- 



120 MKDICAI, HANDBOOK. 

gravated by motion. Rheumatism of the mus- 
cles of the chest has severe pain accompany- 
ing the act of breathing. 

Treatment. — Rest is of first importance. 
Belladonna and Camphor liniments may be 
rubbed well into the parts. There are many 
liniments that are of value for muscular rheu- 
matism. Any counter irritant will usually af- 
ford relief for a time at least. Porous plasters 
have won quite a reputation for relieving the 
pain of rheumatism. Internally Dulcamara, 
Gelsemium, Bryonia, Arnica and Chamomilla 
may be given, as the indications may call for 
these remedies. 



SCARLET FEVER. 

Scarlet fever is an acute contagious disease 
characterized by high fever, rapid pulse, sore 
throat and a scarlet rash of the body. After 
exposure the disease may develop within a few 
hours, or in a few days, usually within the 
first week. The poison of scarlet fever is hard 
to destroy and clothing may transmit the dis- 
ease after years of disuse. One attack does 
not render the patient immune, but those who 
have had the disease are less liable to acquire 
the affection than those who have never had 
it. 

The disease begins suddenly. The child 



SCARLET FEVER. 121 

feels sick, looks pale, is nauseated and may 
vomit. The throat is sore and the pulse is 
rapid, and the temperature is usually high 
(105 F.). Convulsions often are present at the 
onset of scarlet fever. If the temperature is 
high at once and all the symptoms are very 
marked the case will likely be a severe one. 

The temperature continues to rise from the 
beginning for about twenty-four hours or until 
the eruption appears. The eruption appears 
on the neck first and looks like little spots 
sprinkled over a bright red skin surface. From 
the neck the rash extends over the chest, and 
then over the entire body, as well as upward 
over the face. The rash of scarlet fever dis- 
appears on pressure and slowly regains its 
color after the finger has been removed, and 
a line drawn by the fingernail remains white 
for a short time. The throat is painful and 
swallowing is difficult. The glands below the 
tongue are swollen. The tonsils and soft 
palate and walls of the throat are deeply in- 
jected and red, and may even be covered with 
a membrane. The tongue at first is coated, 
while the edges and tip remain clear and red. 
In a few days the coating of the tongue disap- 
pears and the little papilla of the tongue are 
seen to be prominent, making a strawberry 
appearance. 

The fever of scarlet fever rises abruptly for 
the first twenty-four hours and continues high 



122 MEDICAL HANDBOOK. 

for three or four days, and then gradually 
falls to normal. The pulse and breathing are 
both much increased, more than the severity 
of the other symptoms would indicate. The 
appetite is lost and the patient is restless, un- 
able to sleep and often delirious. Headache 
is usually present. There is a great tendency 
in the latter stages of scarlet fever to involve- 
ment of the kidney. The urine is scant and 
high colored. 

In acute sore throat there are many symp- 
toms resembling scarlet fever, but the fever 
is not so high and the pulse and breathing 
not much increased. In measles the throat is 
not to severely attacked; the rash of measles 
appears later and begins on the face instead 
of the neck and the fever falls after the first 
day, to rise on the third or fourth day. In 
diphtheria the symptoms do not appear as 
rapidly as in scarlet fever and there is great 
prostration ; a false membrane is always pres- 
ent and there is no skin eruption in diphtheria. 

Treatment. — The patient should be isolat- 
ed. Rest in bed is imperative. The surface 
of the body should be anointed daily with 
some pure oil or cold cream or carbolized 
vaseline. The food should be liquid and the 
throat should be kept clean by a spray of lis- 
terine, diluted in water ; or Permanganate of 
Potash may be used, y* grain to a half glass 
of water, as a gargle. 



SMAU>POX. 123 

If there is high fever it is best to reduce it 
by giving a sponge bath, using gradually 
cooler water as the bath is given. This bath 
to be under blankets and free from all ex- 
posure. Aconite, Belladonna and Lachesis 
may be given internally as symptoms may re- 
quire. The bowels should be kept moving or 
not allowed to become constipated. Water 
may be given freely. 



SMALL-POX. 

Small-pox is an acute contagious disease 
characterized by an eruption, which is at first 
papular or of pimples, then vesicular or small 
blisters, and finally pustules. Intense pain in the 
lumbar region of the back is always present. 
The fever subsides partially on the fourth day 
and again reappears on the seventh or eighth 
day, and lasts with intermissions during the 
pustular stage. The more the pustules, the 
more marked the fever. 

The germ of small-pox is very hard to de- 
stroy and remains virulent for many months 
on clothing and other places where it may 
have been deposited from the body of one 
affected unless disinfection has been very 
thorough. No age or sex is immune unless 
protected by a previous attack. Vaccination 
may not render a person immune, yet those 



124 MEDICAL HANDBOOK. 

who have been vaccinated do not contract the 
disease as readily as unvaccinated persons, 
and if they do contract the disease the dan- 
gers and course of the disease are reduced and 
the symptoms are much more mild than 
among unprotected persons. 

After exposure the period of incubation is 
about twelve days before the disease appears. 

Small-pox usually begins with a chill or 
with chills, vomiting and intense pain in the 
lumbar or lower region of the back. The 
temperature goes to 104 F. in the first twenty- 
four hours and remains high for three or four 
days. The pulse is quick and full. In chil- 
dren the disease and fever is apt to begin with 
a convulsion. 

Chills followed by vomiting and intense pain 
in the back should lead one to suspect small- 
pox. 

The temperature, which has been high for 
three or four days, lessens and is not a prom- 
inent feature of the disease until about the 
eighth day, for after the eruption is all out 
and the vesicles are turning into pustules then 
the temperature again rises in proportion to 
the number of pustules. After pustulation 
the fever fluctuates for a few days and gradu- 
ally disappears. 

The eruption of small-pox appears about 
the third or fourth day in the form of red 



SMAU>POX. 125 

spots on the forehead and along the margins 
of the hair and also on the wrists. The red 
spots rapidly change into smooth, round 
pimples, which feel like shot under the skin. 
Within twenty-four hours the eruption ap- 
pears on other parts of the face, on the limbs 
and on the trunk. As the eruption appears 
the fever subsides and the patient is more 
comfortable. About the sixth cr seventh day 
of the disease, or about three days after the 
appearance of the shot-like pimples, the erup- 
tion changes into vesicles or small, clear blis- 
ters that are depressed in the center or umbili- 
cated. On the eighth day, or one or two 
days after the vesiculation or blistering, the 
vesicles change into pustules. They first be- 
come milky in appearance and then lose the 
umbilicated appearance. The fluid finally be- 
comes more turbid and is changed into pus. 
Between the pustules there is apt to be swell- 
ing and the features may be greatly changed. 
The fever becomes high again with the de- 
velopment of pustules. In about three days 
after pustulation the pustules break and emit 
an offensive odor and form soft yellow crusts, 
which adhere to the skin for six or eight days 
and then fall off, leaving permanent pock 
marks where the- pustules were developed. 

In some cases the eruption may be scatter- 
ed and in others the eruption may run to- 
gether and form large crusts and sores. The 



126 MEDICAL HANDBOOK. 

larger and deeper the pustules the more se- 
vere the case. 

There may be a fetor of the breath and 
cough due to the development of the lesions 
within the air passages. 

VARIOLOID. 

Those who have been vaccinated develop 
only a mild form of small-pox, to which the 
name of A^arioloid has been given. One who 
has not been vaccinated may contract small- 
pox in its severest form from a mild case of 
varioloid. 

The protection guaranteed by vaccination is 
more in the lessening of the severity of an 
attack than the rendering of the individual 
immune to the disease, though vaccinated 
persons are less liable to contract the disease 
than unvaccinated ones. 

The symptoms of varioloid are the same as 
those of small-pox, but much more mild in de- 
gree. 

Treatment. — Preventive treatment in the 
form of vaccination is to be recommended for 
every person young and old. When a case 
develops in a house every member of the 
household should be vaccinated at once. The 
patient should be isolated in a room that is 
cool and well ventilated. The diet should be 
of easily digested food, or be of liquid food. 
Plenty of water or acid drinks should be al- 



SCURVY. 127 

lowed the patient or encouraged if necessary. 
If the stomach is irritable Bismuth may be 
given 5 to 10 grain doses. The nose and 
throat should be kept clean by sprays and 
gargles. If the pulse becomes weak give 
stimulants. Cleanse the eyes several times a 
day with a saturated solution of Boracic Acid. 
If the fever becomes dangerously high there 
may be need of cold sponging to reduce the 
fever. Sponge under cover and gradually 
reduce the temperature of the water. 

When the pustulation takes place the room 
should be kept darkened and cool. Cloths 
wrung out of a mild Carbolic Acid solution 
will be soothing to the face, or carbolized 
vaseline may be used as a dressing to pre- 
vent deep pitting of the face. 



SCURVY. 

The essential cause seems to be due to an 
insufficient diet of fresh fruit and vegetables. 
Scurvy has been known from the earliest times 
and has prevailed particularly in mining and 
army camps and among sailors. The disease 
develops among those who have subsisted for 
a prolonged period on a diet which is lacking 
in fresh vegetables or their substitutes. The 
blood is changed to a dark red and has a 
tendency to infiltrate the various tissues and 



128 MEDICAI, HANDBOOK. 

organs of the body. Haemorrhages occur into 
the internal organs, the mucous membranes 
and the skin. 

Symptoms. — Early there is pallor and pro- 
gressive weakness. The gums become swollen 
and bleed easily and the teeth become loose or 
fall out. The tongue becomes swollen and 
coated and the breath is very offensive. The 
mucous membrane of the mouth may have 
blood blisters varying in number and size. 
The skin is dry and harsh. Blood spots ap- 
pear on the legs and then on the arms and 
body, and resemble the bites of a flea, only 
that the spots begin around the roots of the 
hair. When the extravasation of blood is 
marked there may be some swelling due to 
these blood spots. Swelling or dropsy about 
the ankles or knees is quite common. Nose 
bleed is frequent, and at times blood may be 
passed from the bowels. Constipation or 
diarrhoea may either one be present, the ap- 
petite lost, the mind become depressed and 
gloomy; headache and delirium are not un- 
common symptoms. 

Treatment.' — The object in treating scurvy 
is to supply the system with the articles of 
food that have been lacking in the diet of 
those affected. Fresh vegetables, the acid 
fruits, such as lemons and oranges and ber- 
ries, may be given first place. The tender 
grass roots from the marshes have been used 



SCURVY. 129 

with marked benefit and a tea made from the 
bark or needles of the spruce tree has helped 
many a miner and Eskimo. Willow buds 
have been used with much benefit by some. 
Fresh meats are very much to be desired, as 
well as fresh vegetables. Lime water should 
be given if obtainable, and may be given with 
milk or as the patient prefers, 2 or 3 table- 
spoonfuls with each meal. The mouth of all 
patients suffering with scurvy should be kept 
clean. The various mouth washes given for 
sore mouth may be used or the mouth cleans- 
ed with a cherry red solution of Permanganate 
of Potash. 

INFANTILE SCURVY. 

Bottle fed infants or nursing babes where 
the mother has been deprived of fresh vege- 
tables for a continued season are predis- 
posed to scurvy. 

Symptoms. — Progressive pallor, loss of ap- 
petite, profuse sweating, especially about the 
head; slight fever attacks at times, and a sen- 
sitive condition in the bones, especially about 
the joints. The child cries when the affected 
limb is touched. The pain in the limb may be 
mistaken for paralysis. The child is afraid to 
be handled on account of the pain. If the 
child has teeth the gums will have the char- 
acteristic symptoms. Slight blood spots may 
be seen on the forehead and in the mouth. 

9 



I30 MKDICAI, HANDBOOK. 

Treatment. — The change of food to fresh 
milk and the juice of one orange a day is all 
that is necessary to bring about rapid recovery. 
Where fruit cannot be had fresh berries may 
be substituted, and if the babe is nursing any 
fresh vegetable given to the mother will supply 
all that is needed in the milk. 



THE SKIN. 

The skin of the body protects the tender 
structures beneath from injury and prevents 
the entrance of poisonous substances from 
without when brought in contact with the 
body. The skin will absorb medicines or 
poisonous substances if applied in the right 
form as ointments, salves, etc. The skin ex- 
cretes much waste matter from the body and 
should be kept active and clean. The sweat 
ducts may become clogged and give rise to 
pimples and comedones. When freely perspir- 
ing one should not go at once into the open 
air or into a draught, as chill is likely to 
stop the action of the sweat glands and send 
back the waste matter that should have been, 
thrown of! by the skin onto the other ex- 
cretory organs to dispose of, thus making 
extra work for the lung, kidneys and bowels. 
A condition of disturbed excretion of the 
skin, associated with irritation of the lungs 



TONSII^ITIS OR OUINSY. I3I 

and bronchial membranes, constitutes what is 
commonly known as a cold. 



TONSILLITIS OR QUINSY. 

Quinsy occurs at all ages, but is most com- 
mon during young adolescence. Exposure to 
cold and damp usually brings on an attack. 
After exposure the throat becomes sore, there 
is pain at the angles of the jaw, which is 
aggravated by chewing, talking and swallow- 
ing. Chills, fever, headache and a general 
tired ache of the whole body is often present. 
The tonsils become swollen, and the crypts 
are filled with a creamy exudate, and the ton- 
sil presents a spotted appearance. In diph- 
theria the tonsils are covered with a gray 
membrane, which is uniform and not dotted 
over the tonsil. The diphtheritic membrane 
creeps up along the walls of the throat to the 
soft palate, while the spots of tonsillitis re- 
main on the tonsils. The patches of tonsillitis 
leave no raw surface when removed as does 
the membrane of diphtheria. In tonsillitis the 
tongue is furred and the breath has a foul 
odor. The urine is scant and high colored. 

Treatment. — Early where there is chill 
give Aconite, 1 tablet every half hour for 
five or six doses. 

Where the throat is very sore and the con- 



I32 MEJDICAI, HANDBOOK. 

stittitional symptoms are few give Guaiacum, 
1 tablet every one to two hours for a day or 
two. Painting the tonsil with baking soda or 
Soda bicarbonate will often afford relief. 
Paint every two or three hours. 

Gargle the throat three or four times a day 
with the following: 

1^. Borax, 1 drachm. Glycerine, two 
drachms. Water, eight ounces. 

A simple and efficacious gargle may be made 
by adding one-half grain of Potassium Per- 
manganate to a glass of water. Gargle the 
throat frequently. 



QUINSY. 

The neck may be painted with Tr. Iodine 
once or twice a day with some benefit. 

When in tonsillitis or quinsy the tonsil is 
much swollen and chill and fever is present 
with difficult swallowing, ix Hepar sulphur, 
1 tablet every hour, will hasten the opening of 
the abscess which is forming in the tonsil. 
Plot poultices will be very grateful to the pa- 
tient, relieving much of the pain. 

throat remedies and indications (dr. h. s. 
weaver). 

In catarrhal conditions of the nose, where 
there is discharge or crusts, cleanse by spray- 



SORE THROAT. 133 

ing or drawing into the nose from the hand a 
solution of salt in water, one-half drachm to 
one-half glass of water. Follow the cleans- 
ing of the nose with an oily spray such as : 
1^. Menthol, ten grains. Acid carbolic, 
five grains. Oil Eucalyptus, one-half drachm. 
Fluid Alboline, two ounces. 

SORE THROAT. 

Belladonna is indicated where the throat is 
red and inflamed, the skin dry and hot, head- 
ache and the face is flushed or red. Give 
Belladonna ix, one tablet every two hours. 

Guaiacum is indicated where the throat is 
sore, red and inflamed, but the patient is not 
feverish as he is when Belladonna is needed. 
There may be some rheumatic symptoms. 
Give Guaiacum 0, one tablet every two hours 
for one or two days. 

Mercurius iodatum rubrum is indicated 
when the tonsils are full of patches, showing 
a distinct tonsillitis. 

Give 2x, Merc. iod. rub., one tablet every 
hour, alternating with Belladonna as indicated 
above, which is to be given every two hours. 

Hepar sulphur is indicated in quinsy when 
the tonsil is red and swollen, with sticking 
pain on swallowing. 

Give Hepar sulphur ix, one tablet every 
alternate hour with Guaiacum as indicated 
above. Early in quinsy these two drugs may 
abort an attack of quinsy. 



134 MEDICAI, HANDBOOK. 

Aconite is indicated where there is cold in 
the head with rapid pulse and chilliness of the 
body. The skin is hot and dry. There is 
fever and restlessness. 

Give Aconite, one tablet every hour for 
five doses. 

Gelsemium is indicated where there is chilli- 
ness alternating with fever. A great deal of 
sneezing and headache in the back of the head 
or pain in the eyeballs. Gelsemium is espe- 
cially good when the cold is beginning. Give 
Gelsemium, one tablet every hour. 

Arsenicum album is indicated where there is 
much watery discharge from the nose, which 
excoriates the nostrils and makes the nose 
burn and look red. There is also sneezing and 
great thirst with dryness of the lips. 

Give 3x Arsenicum alb., one tablet every 
two hours. 

Euphrasia is indicated where the eyes water 
and burn, along with other symptoms of cold 
in the head. Give 2x Euphrasia, one tablet 
every hour. 

Pulsatilla is a prime remedy when the dis- 
charge from the nose has become thick and is 
of a greenish color. 

Give Pulsatilla, one tablet every two 
hours. 



CATARRH OF NOSE AND THROAT. I35 



GARGLES. 

Potassium permanganate, one-half grain to a 
tumbler full of water, makes one of the best 
gargles for tonsillitis and diphtheria. 

For simple inflammation of the throat or 
tonsils and pharynx use — 

Ji. Alcohol, Glycerine, Hamamelis fl. ext, 
Water, aa, equal parts. Used as a gargle is 
very soothing. 

APPLICATIONS. 

In chronic catarrh or sore throat the throat 
may be painted with the following : 

1^. Glycerine, one ounce. Tr. Iodine, five 
grains. Mix, and apply with brush. 



CATARRH OF NOSE AND THROAT. 

Chronic catarrh of the nose and throat is 
very often the result of repeated attacks of 
acute nasal catarrh. Mouth breathing is very 
apt to set up a chronic catarrh of the throat. 
There is apt to be clogging of the nasal pass- 
ages. Crusting of the discharges in the nose. 
Hypertrophy of the mucous membrane of the 
nose. Persistent discharge that is tenacious 
and perhaps offensive. There may be in- 
volvement of the vocal cords when the catarrh 
travels down the air passages. 



I36 MEDICAI, HANDBOOK. 

Treatment. — The nose should be cleansed 
by drawing into the nostrils a solution of 
soda water or salt water, one drachm or one 
teaspoonful to a pint of water. Cleanse the nose 
thoroughly but do not blow the nose for some 
time after drawing the solution into the nos- 
tril. The tendency is to blow the nose, but 
the danger is to force the solution into the 
tubes leading to the ears if the nose be blown. 
Nasal sprays that will reduce the inflammation 
are valuable. 

Internal medication is of much value. 
Hydrastis Canadensis 0, one tablet, three 
times a day. Where the discharge is stringy 
and tenacious and yellow in color. Hepar 
sulphur 4X, one tablet three times a day, may 
be serviceable where the discharge is purulent 
and the breathing is obstructed. 

It is well to look up the different remedies 
and choose the one that is most indicated. 

Avoid mouth breathing, and if possible con- 
sult some good physician. 



PHARYNGITIS, OR SORE THROAT. 

The causes of sore throat are much the 
same as those of quinsy, exposure to damp 
and cold usually causing an attack. The on- 
set is often accompanied by chills and fever 
and a red, swollen and painful throat. There 



CHRONIC SORE THROAT. I37 

is tickling and dryness of the throat and sore- 
ness on swallowing. There is a constant de- 
sire to cough or cleanse the throat. Hoarse- 
ness, loss of voice and impaired hearing are 
apt to be present. 

Treatment. — The same local treatment as 
that used in quinsy is applicable. The bowels 
are often constipated and should be moved. 
Aconite, one tablet every hour for six 
doses, where there are chills and fever, ix 
Belladonna, one tablet every hour where the 
throat is red and inflamed and the skin dry 
and hot. Guaiacum, one tablet every two 
hours, where the throat is sore and there is 
little else of which the patient complains. 

Painting the neck with Tr. Iodine is often 
good in sore throat and in quinsy. A little 
coal oil sprinkled on a cloth and tied around 
the neck until the skin is red but not blistered 
will often help. 



CHRONIC SORE THROAT. 

For chronic sore throat the throat may be 
painted every few days with the following: 

]^. Iodine, five grains. Glycerine, one 
ounce. Paint with brush or swab with a little 
cotton in a forceps. 

The following may be used instead of the 
Iodine preparation: 



I38 MEDICAL HANDBOOK. 

]^. Acid, tannic, ten grains. Glycerine, 
one ounce. Paint the throat every three days 
with brush or swab. 

In acute sore throat use Zinc chloride, ten 
grains, to one ounce of Glycerine. Paint the 
throat daily for four or five days. 



TYPHOID FEVER. 

Typhoid fever is an acute infectious dis- 
ease, caused by the presence and action of a 
bacillus in the intestines. The characteristic 
symptoms are fever and headache, stupor and 
dull, heavy expression of the face, abdominal 
distension with spots that develop on the ab- 
domen about one week after the onset of the 
disease. Diarrhoea of a yellow color is very 
common. The period of incubation is from 
two to three weeks. The disease lasts from 
three to six weeks. 

There are always ulcers of the small intes- 
tines no matter how mild the attack. The 
mildest case is in danger, and there is hope of 
the most severe to recover. 

The disease begins with vague pains over 
the body, languor and weakness, headache, 
nose-bleed, bad taste in the mouth and furred 
tongue and diarrhoea. 

The temperature rises a little higher each 
day until the seventh day in some cases, and in 



TYPHOID FKVKR. 139 

others gradually rising until the fourteenth 
day. One-third of the time is consumed until 
the fever reaches its height, or about 105 ° 
F. One-third of the duration of the attack the 
fever remains high, and the remaining third is 
marked by a gradual lessening of the daily 
fever height. The daily variation in the fever 
is from two to three degrees. In the after- 
noon and evening the fever is higher than In 
the morning. In protracted cases the daily 
variations or remissions are not very marked. 
A marked and rapid fall in the temperature 
may indicate intestinal haemorrhage or rupture 
of the intestine into the abdominal cavity. 
The face of a typhoid patient is dull and 
heavy, the cheeks often flushed and the pupils 
dilated. There is slowness of thought, and an- 
swers come slow and often as if the patient 
had forgotten the question. Headaches and 
stupor with impaired hearing are almost al- 
ways present. Sleeping with the eyes open, 
muttering delirium and picking at the bed- 
clothing or at imaginary objects may develop 
during the disease. The breathing is more 
rapid than usual, but not as frequent as would 
be expected from the height of the fever. 
There is apt to be present a slight cough. 
The pulse becomes rapid and weak, but is not 
as rapid as would be expected with a high 
temperature. The cause of all the symptoms 
is found in the intestines, and we should look 



140 MEDICAL HANDBOOK. 

to the digestive organs for the confirmation 
of our diagnosis. At first the tongue is 
tremulous and coated white, except the edges 
and tip, which are red and free from any 
coating. Late in typhoid the tongue may be 
coated dark brown and fissured, and a deposit 
form on the teeth. The patient usually has 
little or no appetite, though food is seldom re- 
jected by the stomach. In some cases vomit- 
ing may develop. The abdomen is always dis- 
tended with gas, and may be tender. Rum- 
bling or gurgling may be present. Diarrhoea 
is very common, though not always present. 
The movements are yellow, and on standing 
separate, a scum rising to the surface and a 
yellow sediment remaining below. If con- 
stipated, the yellow color is apt to be present. 
The movements are offensive whatever their 
nature may be as to constipation or diarrhoea. 

About the end of the first week from the 
onset of the symptoms there appear on the 
abdomen spots like flea bites, or reddened, 
slightly elevated spots, which disappear on 
pressure. 

Always look for the enlarged abdomen and 
the spots by the end of the first week. The 
urine is scant and high colored. 

During convalescence the hair is apt to fall 
out. , 

Irregularities. — At times all the symptoms 



TYPHOID FEVER. 141 

disappear in a few days. Some cases are so 
mild that the patient refuses to go to bed, 
but the danger is there until the intestines have 
had time to become free of the germs and 
healed of the ulcers. 

Children may have a high temperature at 
once and violent delirium or threatened con- 
vulsions, and, though the abdomen becomes 
distended, the characteristic rash may be ab- 
sent. Relapses in typhoid fever are not in- 
frequent, and are usually not as severe as the 
original attack. 

Temporary elevations of temperature dur- 
ing convalescence may be due to constipation 
or improper feeding. 

Treatment. — There is no disease where 
rest in bed is more indicated. The patient is 
not even to get out of bed to move the 
bowels, but must use the bed-pan. The in- 
testines are uclerated, and exertion or im- 
proper food may cause a fatal result by 
rupturing the bowel into the abdominal cavity. 
The movements should be burned or disin- 
fected by some strong antiseptic. Soiled 
articles of dress or bedding should be 
thoroughly boiled. The nurse and family 
should know that it is the discharges from the 
body that are infectious, and use every pre- 
caution not to infect others. 

No solid food can be given lest the ulcerated 



142 MEDICAL HANDBOOK. 

intestines rupture as a result of such irrita- 
tion. Liquid diet is indicated throughout the 
disease, and after recovery for some time, be- 
cause the appetite is very strong after re- 
covery, and this caution is doubly imperative 
lest the eating of solid food be too much for 
the intestines that are not yet well. More 
than one person has died from eating too 
much and too solid food during convalescence. 
Milk is the best food. To the milk brandy 
may be added if the circulation and diges- 
tion is poor. Beef tea and meat broth may be 
given to vary the diet. Water may be given as 
much as desired, and if not desired it is desir- 
able to give water at any rate at regular inter- 
vals. If constipation should be present the bow- 
els should be moved by enemata, and by small 
doses of Calomel. High temperature may be 
reduced by the gradual cold sponging under 
woolen blankets. It may be advisable to check 
a diarrhoea by giving Bismuth subnitrate in 
ten-grain doses, repeated two or three times a 
day. Heart failure, constipation, high fever 
and delirium must be met as the occasion de- 
mands. 

The drugs, Bryonia, Aconite, Hyoscyamus, 
Baptisia, Quinine, Whiskey, Calomel, and 
Strychnine may, one or more, be indicated 
during the course of the disease, and should 
be given as occasion and indications require. 



TOOTHACHE. 

Before placing anything in an aching cavity 
remove all particles of food and thoroughly 
cleanse the cavity. Saturate a small piece of 
cotton with one of the following solutions 
and place it in the cavity; put over this a 
small piece of dry cotton : 

IJ. Tr. Aconite, one drop on cotton, apply 
to nerve in cavity and cover, 

R. Cocaine muriate, four per cent, solu- 
tion. Laudanum, Chloroform, equal parts of 
each of the above. 

Saturate a small piece of cotton and apply 
as before, or instead of the above, saturate the 
cotton with Oil of Cloves or Camphor- 
Phenique, and apply as before stated. In- 
stead of the foregoing the cavity may be 
cleansed and a small piece of toothache gum 
may be placed in the cavity. 



THE TONGUE. 

The tongue is worthy of some study, as it Is 
indicative of several disorders of the system. 
A thick, flabby, gray-coated tongue that shows 
the imprints of the teeth indicates disturb- 
ances of digestion in general, and is also 
noted in connection with appendicitis. In 



144 MEJDICAL HANDBOOK. 

brain diseases the tongue may be sharp- 
pointed, tremulous and difficult of motion, 
and in some lesions of the brain the tongue is 
always protruded to one side. An immobile 
tongue or one that always protrudes to one 
side indicates paralysis due to pressure or in- 
jury of the nerves of the tongue or to brain 
tumor. The sharp red tongue is common with 
brain fever. In typhoid fever the tongue is 
coated from gray to very dark, depending on 
the time and state of the irritation of the in- 
testines. Indigestion has a gray-coated tongue 
clear on the edges. 



NORMAL TEMPERATURE. 

The normal temperature of the body is from 
98 to 100 degrees F. During sleep there is a 
slight fall of the temperature amounting to 
1 or 1^2 degrees. Elevations of temperature 
are common, and are associated with many 
affections. Elevations in temperature are less 
dangerous than marked reduction of the tem- 
perature. The favorite localities for the tak- 
ing of the temperature are in the mouth under 
the tongue and in the axilla. Axillary tem- 
perature is likely to be a degree or so lower 
than that taken under the tongue. It is best 
to take the temperature of infants and 
delirious patients per rectum. This is safer 
and more reliable, since children will not hold 
still. 



TAPE-WORMS. 

Tape-worms are found as an affection of 
meat eaters. Infection ensues in the fol- 
lowing way: The eggs of the worm are first 
ingested by some animal called a host, where 
the embryo worm is hatched and passes into 
the different tissues of the body; in this con- 
dition it remains undeveloped and forms what 
is known as measles in the meat. There is a 
tape-worm from the beef, the hog and from 
fishes, any of which may develop in man, and 
though slightly different owing to the source 
from which the worm comes the treatment is 
the same for any of the several varieties. 

Symptoms. — The symptoms of tape- worm 
are not to be relied upon as proof for or 
against the presence of the worm. There may 
be no symptoms at all, or there may be colic, 
or a varied appetite. Itching of the nose may 
be present, and occasionally there is vertigo. 
The only sure symptom is the finding of seg- 
ments of the worm in the stool. 

Treatment. — Either of the following 
methods are easy as well as reliable : 

^. Hulled pumpkin seeds, three teaspoon- 
fuls. Bruise the seeds well and cover with 
water and let stand for twelve hours. Take 
at one dose, and in three hours take a prompt 
acting purge, such as a large dose of Castor 
oil. 

10 



146 MKDICAL HANDBOOK. 

Or the following treatment may be em- 
ployed : 

R . Oleoresin male fern, one teaspoonful. 
Give at one dose, or give in one- fourth tea- 
spoonful doses, fifteen minutes apart. Four 
hours later give a prompt acting purge as 
above stated. 

The day before taking the treatment the 
patient should take a mild purge and eat only 
liquid diet. 

When the head of the worm is removed the 
worm is removed. If the head is not expelled 
the worm will continue to grow and will ap- 
pear in the stools in segments. 

All excreta of one suffering from tape-worm 
should be burned, as some animal used for 
food may be infected. All meats should be 
thoroughly cooked before being eaten, and 
measly meat should be rejected. 



TUBERCULOSIS OR CONSUMPTION. 

Consumption is due to the tubercle bacillus, 
and is an infectious disease. Those having 
the disease should not expectorate where the 
sputa afterwards may become dry and pow- 
dered and carried in the air to the lungs of 
others. 

The germ of consumption may invade any 
part of the body. When attacking the lungs 



TUBERCULOSIS OR CONSUMPTION. 147 

tubercle bacillus sets up what is commonly 
called consumption. If the brain is attacked 
there is acute or chronic meningitis. If the 
intestinal cavity, chronic peritonitis, and if the 
bones be invaded the result may be curvature 
of the spine, hip-joint disease or swelling of 
the joints and bones elsewhere. The glands 
may be involved, as is shown by what Is 
usually called scrofula. 

Treatment. — The locality attacked will be 
subject to symptoms that will require treat- 
ment as occasion demands. 

There is no known cure for the tubercle 
bacillus. Good nourishing food, plenty of air 
and sunshine are to be strongly advised. We 
can only assist nature by giving her all the 
good food and fresh air she can use. In the 
system nature tends to destroy the germs and 
prevent their dissemination by throwing out 
inflammatory circles or capsules around the 
bacilli, to entomb the germs in the capsule 
thus formed. 

Tonics are of much value in causing better 
digestion. The fat producing foods are of 
especial value to give the circulation plenty of 
material . to use up in the resistance that must 
be made. Any undue strain should not be 
put on the system, as she has enough already. 
Maternity is especially contra-indicated to 
those who are tubercular, the mother being 
much endangered by pregnancy, since the dis- 
ease is poorly resisted during pregnancy. 



URINE. 

Healthy urine is of an amber or straw color. 
In health the quantity passed in twenty-four 
hours should be from 2^4 to 3 pints. Food 
and drink and the amount of perspiration 
modify the output of urine. If more water is 
passed the color is usually lighter, if less, 
darker. In fevers the urine is usually scant 
and high colored. In nervous disorders it 
often is profuse and very light colored. 
Smoky, colored urine is found where there is 
blood present from the kidneys or bladder. 
In pregnancy the urine is often quite red and 
leaves a brick-red sediment on the sides and 
bottom of the urinal. Normal urine has some 
froth that rapidly leaves it, but if the froth 
remains for a long time some kidney or liver 
disease may be suspected. Cloudy or turbid 
urine is met with in inflammation and blood 
poison. 



WHOOPING-COUGH. 

Whooping-cough is an infectious disease, 
so named from the peculiar long drawn whoop 
following a paroxysm of coughing. The dis- 
ease is one of the respiratory organs, and in 



WHOOPING-COUGH. 149 

many respects resembles a cold in the head 
and chest. Children are more prone to the 
disease than adults, but any one may acquire 
the disease. One attack prevents or renders 
the individual immune to the disease in after 
years. 

Whooping-cough begins as an ordinary cold 
in the head with slight fever, sneezing, run- 
ning at the nose and cough. In the course of 
ten days or two weeks the cough, which 
has resisted all treatment, becomes paroxys- 
mal, or excited coughing spells develop. 
During the coughing spell the face becomes 
blue, the eyes injected with blood, and the 
veins of the neck and face are seen to become 
engorged. Vomiting is very apt to result from 
the cough, and the child may become poor 
from inability to keep food on the stomach. 
Nose-bleed is apt to occur as a result of the 
engorgement of the veins of the head from a 
paroxysm of coughing. The small arteries or 
veins in the white of the eye at times rupture, 
and the white of the eye may be blood red, of 
one or both eyes. When the paroxysm of 
coughing is over there always occurs a long 
drawn inspiration accompanied by whooping 
or crowing sound that when once heard will 
not be forgotten. The stage where paroxysms 
exist may last from three to four weeks, and 
the number of paroxysms of coughing may 
reach thirty or forty in a single day. 



150 MEDICAI, HANDBOOK. 

After three or four weeks of the cough 
and whoop the paroxysms become less fre- 
quent and finally cease. In some cases the 
disease only lasts a few weeks, and in others 
it may be extended over a period of two or 
three months. 

Complications affecting the lungs, haemor- 
rhages in the eye or ear, convulsions and 
chronic cough may follow. 

Treatment. — There is little use to give the 
expectorant cough medicines for whooping- 
cough, for the disease will run a certain 
course do what you will. It is of far greater 
importance to keep up the strength of the 
patient by careful and systematic feeding. If 
a child vomits after a paroxysm of cough- 
ing immediately feed the child no matter how 
often the emptying of the stomach may make 
feeding necessary. There will be times be- 
tween the paroxysms that will be of sufficient 
length for some of the food to be digested 
and pass from the stomach into the intestines. 
Milk or brandy and milk are well borne, 
and also gruels or beef tea as well as the 
liquid foods. Eggs are also a very good food, 
and may be given beaten up with the milk; 
eggs are preferable if given raw. Sometimes 
a hot cloth applied to the chest will relieve 
the paroxysms of coughing at night. A child 
suffering from whooping-cough should not be 
left alone, as choking may occur during a 



PIN WORMS OR SKAT WORMS. 1 51 

coughing spell. When the child does cough 
it is best to take it up and hold the body in 
any position that will assist the expelling of 
the mucus. Bend the body slightly forward 
that the assistance that gravity gives may 
help to remove the mucus, which is very 
tenacious. It is often a very good practice 
to remove with the finger, covered by a towel, 
some of the mucus from the mouth. 

The room should be kept well ventilated. 
At night the steam lamp used in croup may be 
of value, or Cresoline may be used as directed 
on the lamp. 

The inhalation of a drop of Amyl nitrite, 
from a pledget of cotton, may be tried to re- 
lieve the paroxysm. 

Good food and plenty of pure air are the 
best remedies. 



PIN WORMS OR SEAT WORMS. 

This small worm inhabits the large intes- 
tine and in appearance resembles small bits 
of white thread. 

Symptoms. — The most marked symptom is 
itching. The child is ever boring at the nose 
with the finger. Itching of the anus is a 
very common and persistent symptom, and is 
worse in the evening after retiring. Nervous 
symptoms are common. Reflex irritation may 



152 MEDICAL HANDBOOK. 

cause bed wetting. The worms may migrate 
from the anus to the genital tract of girls and 
there set up irritation. Children who have 
worms often are very fond of candy and have 
dark rings under the eyes and around the 
mouth. 

Treatment. — Cleanliness is necessary, for 
the child usually reinfects itself by carrying 
the eggs, after scratching, on the finger nails 
to the mouth in eating. The itching at night 
can usually be relieved by applying a little 
vaseline to the perineum and anus. The lower 
bowel may be washed out daily with an 
enema of salt water, I drachm to the pint. 
If salt water cannot be borne then give an 
ounce of olive oil and follow in a few min- 
utes by an enema of plain water. If the 
hands be kept clean and the worms be daily 
washed from the lower bowel few cases will 
last more than a week or ten days. If the 
worms are hard to dislodge, then one-sixth 
grain of Santonin may be given three times 
a da}^ in addition to the local treatment. 
These measures should cure unless the con- 
ditions are very unusual. If the child is 
dizzy, and there is gastric irritation, and an 
appearance of things being yellow, the San- 
tonin should be discontinued lest too much 
be given. 



WOUNDS. 

By the word wound we understand some 
injury from without, causing a separating of 
the structures to a more or less extent. 

Wounds may be incised, punctured or 
penetrating, as from nails, gunshot and knife 
thrusts. The surface may be broken by bruis- 
ing or cutting. The idea of a wound is that 
the structures have been severed, requiring 
repair or healing. 

Wounds may be clean or aseptic, or 
poisoned by germs that delay healing and 
cause suppuration or sepsis. 

Treatment. — Wherever the injury has oc- 
curred there is required rest and repair of 
the part. As there is always great danger of 
some infectious germs being carried into a 
wound the precaution of rendering a wound 
free from such poisonous germs becomes a 
routine duty. Infected wounds are cleansed 
by removing all dirt and lifeless tissue, and 
then by thoroughly bathing the wound sur- 
face in some antiseptic solution, which will 
kill all the germs that may be present. The 
Bichloride of Mercury in the strength of 
Viooo * s usua Hy employed for this purpose. 
After thorough cleansing and disinfecting a 
wound the parts should be coapted or brought 
together by stitches or adhesive plaster. A 



154 MEDICAI, HANDBOOK. 

stimulating dusting powder should be dusted 
over the wound and an antiseptic dressing 
applied. Iodoform and Boracic Acid powders, 
in equal parts, make a good dusting powder. 
Wounds should be cleansed if there are in- 
fected areas that suppurate during healing. 
If pus forms disinfection is again necessary. 

Punctured wounds require opening by free 
incision and thorough cleansing with an anti- 
septic solution. Free bleeding is also to be 
encouraged. Poison carried into the tissue 
by nails or thrusts must be removed and the 
wound made free of all poison. 



ANESTHETICS AND ANESTHESIA. 

ETHER. 

Ether is produced by the action of Sulphuric 
Acid on Alcohol. The properties of ether are 
a clear, colorless liquid of a characteristic 
odor and a sweetish taste. Ether readily 
combines with Alcohol and all of the fixed 
oils, is highly inflammable and its vapor is 
highly explosive when ignited by a light or 
fire. Evaporation is very rapid in the open 
air and the surface on which it evaporates is 
markedly chilled, and even freezing can be 
produced by its evaporation. Ether should be 
used at a remote distance from any lamp, 



ANESTHETICS AND ANESTHESIA. 1 55 

candle or fire. When kept too long there is 
a partial decomposition of the drug, which 
renders it more irritating and less desirable 
for internal use. The chief use of Ether is 
as an anaesthetic. When introduced into the gen- 
eral system it stimulates the heart and cir- 
culation as long as it is given. When fatal 
results occur from Ether it is usually due to 
paralysis of the respiratory centers, and the 
heart is found beating after breathing has 
ceased. There are some subjects in which 
there is loss of sensation, but consciousness 
is not destroyed. Those who habitually use 
Alcohol are often very hard to etherize. Short, 
fleshy people are often poor breathers when 
taking Ether. The effect of Ether is shown 
first on the mind, then on the nerves of sen- 
sation and finally on the nerves of motion. 
Ether is the safest anaesthetic for general use 
and was introduced as an anaesthetic of mark- 
ed value for surgical work in the year 1846. 

CHLOROFORM. 

Chloroform was discovered about the year 
1831, but was not successfully introduced as 
an anaesthetic for surgical purposes until the 
year 1847, since which time it has ranked as 
one of the two anaesthetics of surgery. Chloro- 
form is far more dangerous than Ether and 
should be chosen after Ether has been found 
to be contraindicated. Chloroform is a clear, 



156 MEDICAL HANDBOOK. 

colorless liquid, having a characteristic odor 
and sweetish, burning taste. Soluble in Alco- 
hol, Ether and all fixed oils. Chloroform is 
less inflammable than Ether, less irritant to 
the mucous membranes when inhaled and at- 
tended by fewer unpleasant symptoms than 
Ether, but on the whole it is a much more 
dangerous drug. Ether stimulates, while 
Chloroform depresses the heart and lungs. 
When administered to produce anaesthesia by 
inhalation Chloroform rapidly produces un- 
consciousness, insensibility and relaxation of 
the muscles. The heart is quickened, but less- 
ened in force and volume. Insensibility is 
produced by Chloroform in a few minutes, 
and recovery is attended with little or no 
nausea or vomiting, but fatal results have 
been so much more common from its use than 
from Ether that preference should be given 
to the Ether. 

PREPARATION OF THE PATIENT FOR ANAESTHESIA. 

Solid food should be withheld for one meal, 
or from four to six hours before the opera- 
tion, and liquid food for at least two hours 
before anaesthesia. The bowels should be. 
moved naturally or by enemata shortly before 
the time for operation. False teeth or any 
foreign body in the mouth must be removed 
lest during the anaesthesia they fall into the 
throat and endanger the patient from chok- 



ANESTHETICS AND ANESTHESIA. 157 

ing (always look to this before beginning to 
give the anaesthetic). Loosen the clothes of 
the chest and abdomen and have the patient He 
down before taking Ether. 

THE EXAMINATION OF THE PATIENT BEFORE 
ANAESTHESIA. 

Find out if the patient is subject to fainting 
spells, epileptic fits, chronic heart trouble, 
acute or chronic lung trouble, kidney disease, 
and if the patient is at the time under the in- 
fluence of any drug, and if so, what drug; also, 
if an habitual user of Alcoholic drinks. 

INDICATIONS FOR ETHER. 

Safety demands that Ether should be given 
in all cases where it is not contraindicated. 

CONTRAINDICATIONS TO THE GIVING OF ETHER. 

Since Ether is irritant to the mucous mem- 
branes it follows that it should not be given 
where there is marked throat or lung trouble, 
such as inflammation or narrowing of the 
throat, chronic inflammatory affections of the 
lungs, such as bronchitis, asthma and con- 
sumption or tuberculosis ; also, in the acute 
affections of the lungs whatever the cause 
may be. 2. Ether should not be given to pa- 
tients suffering with either acute or chronic 
renal or kidney diseases. 3. In operations 
about the head Ether is often contraindicated, 



158 MEDICAI, HANDBOOK. 

especially so if the cautery is to be used, or 
if the operation be on the nose or throat. 4. 
In chronic alcoholism. 5. In childbed convul- 
sions (puerperal eclampsia), where an imme- 
diate effect is required. 6. In the very young 
and the very old. 

HOW TO ADMINISTER ETHER. 

First. Try to quiet all fears of the patient 
and then give the patient your whole and un- 
divided attention from the time the anaes- 
thesia is begun until the operation is over 
and the cone removed. 

Second. The anaesthetic should be given 
slowly at the beginning and mixed with 
plenty of air. This is safer and more pleas- 
ant to the patient, less irritant to the mucous 
membrane of the air passages and materially 
lessens the struggling of the patient. 

To administer the Ether the patient should 
lie on the back; the cone is next placed over 
the nose and held with the thumb and fore- 
finger of the left hand. The thumb also resting 
firmly on the bridge of the nose, the little and 
ring finger press from behind the angle of 
the jaw forward and upward. This is neces- 
sary, and should not cease from the begin- 
ning to the end of the etherization lest the 
tongue drop back into the throat and material- 
ly obstruct the breathing. The Ether should 
then be dropped slowly on the cone and the 



ANESTHETICS AND ANESTHESIA. 1 59 

patient told to take long, deep breaths, to 
blow the Ether away, or to count up to 40 or 
50. During the early stage of anaesthesia 
there is liable to be some struggling and there 
should be assistants to hold the limbs. If 
the Ether is given too rapidly there will like- 
ly be some spitting and trouble with mucus 
in the throat. As the operative stage is reach- 
ed the breathing is deeper, the face flushed 
and moist from perspiration. The yielding 
of the jaw, so that it may have the lower 
teeth hooked over the upper, which lessens 
the strain on the ring and the little finger, 
and the absence of the reflex of the con- 
junctiva or of the eye, are indications that 
the operative stage is near at hand. As deep 
narcosis approaches there is often shallow 
breathing, followed by long drawn inspira- 
tions, and the patient may be a little blue. 
Such breathing is not the best, and the cone 
should be removed until the breathing is 
regular, as the giving of much Ether at this 
time is very dangerous, and if any of the 
anaesthetic be given the amount should be 
very small until the breathing is regular 
again, then continue the Ether and keep the 
patient just in the operative stage. 

When the stage for operation is reached 
there will be relaxation of the muscles, ab- 
sence of the conjunctival reflex, and the eyes 
will be steady and the pupil small. After the 



l6o MEDICAL HANDBOOK. 

patient is well under Ether the amount of the 
anaesthetic needed to continue the narcosis 
is small, and it should be given slowly and 
with plenty of fresh air. A large pupil is 
either a sign of returning consciousness or of 
danger, and of itself will not tell if more or 
less Ether is needed. The rolling of an eye 
with a dilated pupil slowly from side to side 
precedes the coming consciousness a short 
time, and the anaesthetist may know by this 
that he should give more Ether, or if the pupil 
is large and the eye fixed or immovable the 
patient is already too far under and the Ether 
should be withdrawn. The anaesthetizer 
should watch the breathing. If long and in- 
cluding the abdominal walls it is good; if 
short and jerky, and only of the chest, danger 
and great danger is near, and the Ether must 
be stopped at once. If there is stertorous or 
noisy breathing the tongue has slipped back 
and the jaw must be brought forward at 
once. The pulse must be watched, and to do 
this the middle finger can rest on the artery 
that crosses the lower jaw between the angle 
and the chin; also, the radial pulse should be 
watched. A dark color of the lips and the 
fingernail indicate that the patient is not get- 
ting enough air, and the cone should be re- 
moved. When the patient has received too 
much Ether the eyes are fixed, the pupils 
dilated and do not contract when exposed to 



ANESTHETICS AND ANESTHESIA. l6l 

light; the breathing short and jerky, the lips 
and fingernails are blue and breathing may 
cease from paralysis of the respiratory nerve 
centers. Remember, the patient deserves your 
undivided attention. Give the Ether slowly 
at first, and very cautiously, just as the pa- 
tient goes into the operative stage. Keep the 
lower jaw forward. Watch carefully the pulse, 
the eye, the breathing and the color of the 
lips and fingernails. 

HOW TO MEET EMERGENCIES. 

Have with you a short piece of wood y 2 
by i by 6 inches to use as a pry in spasmodic 
closing of the mouth. 

A pair of forceps to grasp the tongue with 
in case of accident. Towels to wipe out the 
mouth w r ith in case of choking, and have 
ready Brandy and Strychnine if needed to be 
used as heart tonics. In asphyxia of choking 
from swallowing the tongue, bring the jaw 
well forward, and if necessary draw the 
tongue out of the mouth with a pair of for- 
ceps. Asphyxia from too much ether should 
be met at once with artificial repsiration, as fol- 
lows : Lower the head, hold the jaw well 
forward and the mouth open, let two as- 
sistants take either arm at the elbow and 
carry them up until they meet over the head, 
then down again until they touch the anterior 
surface of the chest, press simultaneously and 

11 



l62 MKDICAI, HANDBOOK. 

firmly on the chest, and then repeat the 
motion. The movements of the arms for aiti- 
ficial respiration should be about sixteen or 
eighteen per minute, not more. Do not stop 
efforts at resuscitation too soon. Dash cold 
or hot water on abdomen and chest, and rub 
the extremities toward the heart. Ice slipped 
into the rectum or the rectal specula will by 
reflex action often promptly restore breath- 
ing. As soon as swallowing returns give 
alcoholic stimulants. Where there is choking 
from foreign bodies in the throat, or from 
mucus, turn the patient on his face and re- 
move substance with the finger and towel. If 
the patient vomits turn him on his side, face 
down, until the mouth and throat are empty. 
Remember last of all that any drug capable 
of producing unconsciousness is not devoid of 
danger, and that cases are lost occasionally 
by the most skilled. Chloroform has more 
than twice the mortality of ether. Ether is 
said to be the direct cause of death of one 
case in 26,000; but those who have not hand- 
led this drug should not use these figures as 
a proof that they will not have this one fatal 
case. If ether is given at night place the 
light well above the patient. Ether vapor is 
heavy and falls to the floor. If explosion 
occur cover the patient's face and set the ether 
can aside, do not throw it lest it burn and the 
trouble be made worse. 



ANESTHETICS AND ANESTHESIA. 163 
THE ADMINISTRATION OF CHLOROFORM. 

The preparation and also the examination 
of the patient and the restrictions of food are 
the same as for ether. 

INDICATIONS FOR THE USE OF CHLOROFORM. 

Chloroform is indicated where ether cannot 
be used and anaesthesia is necessary. 1. 
In acute and chronic affections of the throat 
and lungs. 2. In acute and chronic renal or 
kidney diseases. 3. In chronic alcoholism. 4. 
In night operations where ether cannot be 
used on account of the light or fire. 5. In 
operations about the nose and throat. 6. In 
convulsions of childbed fever (eclampsia). 7. 
In nervous and mental diseases where the ex- 
citing effects of ether cannot be borne without 
danger to the patient. 

CONTRA-INDICATIONS FOR THE USE OF CHLORO- 
FORM. 

I. Chloroform is contra-indicated wherever 
ether can be used. 2. In faintness and weak- 
ness from loss of blood (shock). 3. Epilepsy. 
4. Where there is a tendency to fainting. 5. 
In the various diseases of the heart, and 
where Chloral hydrate has been given shortly 
before anaesthesia. 

To administer chloroform the patient should 
be in the recumbent position. The clothing 



164 MKBICAI, HANDBOOK. 

loosened, false teeth removed, and the fears 
of the patient quieted as much as possible. 
The lower jaw should receive the same care 
as in ether. The cone should not be used, 
but instead a single thickness of some light 
woolen fabric stretched over a frame of suit- 
able shape and size. It will be remembered 
that ether is a stimulant to the heart and 
nerves of circulation; that it is more irritant 
than chloroform to the mucous membrane, 
and that it kills by paralysis of the respiratory 
centers. In ether poisoning breathing ceases 
long before the heart refuses to act, thus giv- 
ing more time and chance for resuscitation 
than in chloroform. Chloroform depresses the 
heart and nerves, and when the heart stops 
the chances of resuscitation are few. Hold 
the inhaler or mask for chloroform two or 
three inches from the nose, and begin by drop- 
ping slowly the chloroform on the mask. As 
soon as the giving of chloroform has begun 
never remove your eye or attention to any- 
thing else than the patient, until the patient 
has recovered beyond the point of danger. 
Never be in a hurry in giving chloroform. 
Usually there is little struggling, and the pa- 
tient passed rapidly into the second or opera- 
tive stage of anaesthesia. Keep the jaw well 
forward. Sometimes in the first stage of 
chloroform there is restlessness, short breath- 
ing and anxiety of the patient ; if this occurs 



ANESTHETICS AND ANESTHESIA. 165 

remove the mask and let the patient quiet a 
little, to push chloroform at this stage is 
dangerous. When the patient is about to pass 
into the operative stage be very careful not 
to give a poisonous or overdose of the drug, 
for with the deep breaths common at this time 
too much chloroform can easily be given. Re- 
member there is no safety but in little chloro- 
form and plenty of air. Watch the eye as in 
ether, and try to keep the patient as near the 
stage of coming out as can be, and yet be 
fully under. It is dangerous to operate when 
the patient is not fully under, but strive to 
keep him just in the operative stage of an- 
aesthesia. In the operative stage of chloro- 
form the pupil is more contracted than in 
ether. Adilated pupil and fixed eye with short 
breathing indicates danger, and the drug must 
be stopped at once. Do not let the breathing 
become noisy, keep the jaw well front. Watch 
the pulse, the breathing, the jaw and the 
color of the lips and finger-tips. If the heart 
is quick and hard there may be too little air, 
raise the mask higher. For choking or vomit- 
ing proceed as in ether. If the pupils become 
dilated, the eye fixed, the respiration shallow 
and the lips blue, stop all chloroform, lower 
the head of the patient, apply friction of the 
limbs towards the heart, and give hypodermic 
injections of heart tonics and of brandy. 
After taking an anaesthetic some one should 



l66 MEDICAI, HANDBOOK. 

watch the patient until he is well out from 
under the influence of the drug. There may 
be vomiting, and some one be needed for this 
as well as to see that from restlessness an 
operated part be not injured. After chloro- 
form the tendency to vomit is not so great as 
after the ether; the patient usually passes into 
a long sleep to awake conscious. The dangers 
of moving are injury to the operated part, or, 
if allowed to rise, added strain may be put 
onto the heart that needs the time following 
the operation to regain its strength. 

LOCAL ANESTHESIA. 

There are different agents used to produce 
local anaesthesia, but for ordinary use we will 
consider only the one drug, Cocaine hydro- 
chlorate. Cocaine hydrochlorate can be se- 
cured in various forms for surgical use, but is 
best in the one-fourth grain tablet. The dose 
is from one-fourth to one grain. The drug is 
used on mucous surfaces by being dropped on 
the place or line of incision about three min- 
utes before the time of using the knife. Small 
operations may be done under the influence 
of cocaine, by first injecting with the hypo- 
dermic needle a little of a one per cent, solu- 
tion along the line of incision. In small ampu- 
tations and incisions the time to cut is about 
five minutes after the injection of the drug. 
There will be no pain felt for about ten or 



ANESTHETICS AND ANESTHESIA. 1 67 

fifteen minutes after cocaine has been injected. 
Where cocaine is used on fingers or toes, the 
member should have a stout ligature or string 
tied around it to retard the flow of blood 
from the part, as it may, if too rapidly ab- 
sorbed, produce alarming nervous symptoms. 

If the patient becomes restless, talkative and 
pale, there has been too much drug given, or 
it has been absorbed too quickly. 

If such symptoms occur have the patient lie 
down and give brandy or other heart tonics 
and allow the use of smelling salts or am- 
monia. 

Overdoses of cocaine may produce pallor, 
restlessness, tremor, syncope, weak heart ac- 
tion, delirium and convulsive fixation of the 
chest and organs of respiration. 

In using cocaine use the drug just where 
you wish to cut. Use as little as will thor- 
oughly deaden the pain. Try to retain the 
drug where it is needed and avoid large veins 
or vascular areas when injecting it. 

For small lancings and minor operations 
cocaine is preferable to using either of the 
stronger anaesthetics. Use the drug with care 
and you will find it very serviceable. If the 
patient begins to talk freely while you are 
using the drug, look at his face, and if he is 
a bit pale, give him at once some brandy and 
have him lie down. Fatal results may occur 
but are not common. Be careful of the use of 



l68 MEDICAL HANDBOOK. 

cocaine at all times, and especially on children 
and the very old. 

ACONITUM NAPELLUS. 

Aconite is usually given in the tincture. In 
moderate doses it slows the pulse and respir- 
ation or breathing, and lowers the tempera- 
ture. 

Use. — In febrile affections, where there is 
a rapid pulse, rapid breathing and mental 
anxiety. In. the early stages of a cold where 
there is fever. Early in quinsy. Sore throat 
and the fevers of children. The dose should 
be i drop in water every hour until the fever 
and pulse are lessened. For children the dose 
should be reduced by adding water according 
to the age of the child. 

HOMCEOPATHIC PREPARATION AND INDICATIONS. 

Dose. — One drop of the tincture every hour 
for 4 or 5 doses, or i drop of the ix dilution 
every hour until symptoms abate. 
Symptoms for which Aconite is indicated: 
Fear and anxiety of mind, fear of death, 
congestion of the head and derness of the 
face, throbbing headache, roaring in the ears, 
nose bleed, dry mouth and continual thirst, 
bitter taste in the mouth, watery, slimy stools, 
small amount of urine that is high colored 
and its passage is associated with burning in 
the bladder. 



REMEDIES. 169 

Aconite is good for neuralgia of the head, 
iety. For colicky, shooting pains in the abdomen, 
For colicky, shooting pains in the abdomen, 
with watery, slimy stools. For fevers where 
there is a hard, quick pulse, rapid breathing, 
mental anxiety and unsatisfied thirst. For 
suppression of the menses from fear or anxiety. 
For pain in the heart that extends down the 
left arm, with rapid pulse after exposure to 
cold. 

For neuralgia 30 drops of the Tr. Aconite 
in an ounce of water makes a very good lotion 
to bathe the face with. 

For toothache 1 drop of Tr. Aconite will 
afford rapid relief, applied on a little cotton, 
and keep the saliva from the aching tooth by 
a pledget of cotton between the tooth and the 
cheek. Early in fevers there is no drug to 
surpass Aconite. From 5 to 10 drops of the 
tincture may be placed in a half glass of 
water and a teaspoonful be given hourly until 
the fever is reduced and the pulse slowed. 
When the fever and pulse have been re- 
duced it is best to stop the use of the drug. 
At all times avoid large doses. It is not ad- 
vised to go beyond 5 to 10 drops in the course 
of any single day. For children make the 
dose less. The tablets are very convenient 
to give. The dilutions are better for the 
chronic conditions calling for Aconite. Never 



I70 MEDICAL. HANDBOOK. 

let the cup of medicine remain where some 
one may drink it by mistake. 

APIS MELLIFICA (HOMCEOPATHIC) . 

Dose, 3x to 6x, i tablet every two hours. 

Symptoms Calling for Apis. — Swelling, 
with burning and tingling in any part of the 
body. The mind is sluggish. Pain in the 
head relieved by pressure. The patient is 
restless and turns from side to side in bed, 
and at times suddenly cries out and screams. 
Puffiness of the eyes and dread of light, 
swollen tongue and swollen tonsils, with diffi- 
cult swallowing and obstructed breathing; 
soreness of the abdomen, greenish, watery 
stool, worse in the morning and an inability 
to retain the movements ; the bowel as it were 
remains open, dark, scant urine ; swelling of 
the limbs, with a waxy, watery appearance ; 
hive-like eruption, with sticking, itching and 
burning pain. 

ASAFOZTIDA. 

Asafcetida is a gum from a Persian plant. 

Dose, I to 3 grains in a pill, two or three 
times a day. 

Asafcetida is a valuable remedy for dis- 
turbances of the nervous system. Hysteria 
and nervous excitement of any kind. 

It is a prime remedy for indigestion, with 
much distension and a feeling of a ball rising 



REMEDIES. 171 

in the throat. For windy rumbling of the 
bowels, with the passage of much gas. 

For nervous indigestion and the disturbed 
digestion of the aged, associated with disten- 
sion, wind and colic, and the belching of 
greasy, rancid tasting food. 

Asafoetida, 3 grains ; Powdered Nnx vomica, 
Y^ grain, in pill, 1 pill after meals, is a good 
remedy for nervous indigestion. 

ASAFOETIDA (HOMCEOPATHIC) . 

Dose, ix to 3x, 2 or 3 tablets, three times 
a day. 

Asafoetida is indicated for hysterical symp- 
toms, nervous excitement, a sensation of a 
ball rising in the throat, belching of rancid, 
greasy tasting food, a windy condition of 
the bowels ; for an all-gone empty feeling of 
the stomach, with gnawing and burning and 
a rancid, greasy taste in the mouth. 

ARSENICUM ALBUM. 

Arsenic is a drug much used by all schools 
of medicine. 

In regular medicine Arsenic is used for 
nervous affections, such as St. Vitus' dance, 
neuralgia and for diabetes, consumption, 
rheumatism, malaria and diseases where 
there is a chronic, warty thickening of the 
skin. Arsenic is usually given in Fowler's 
solution. The dose is from 1 to 5 drops 
(given in water) three times a day. 



172 MEDICAL. HANDBOOK. 

Begin *with a small dose and increase the 
dose gradually from day to day. Puffy swell- 
ing of the eyes in the morning and looseness 
of the bowels, with colic, are signs that enough 
of the drug has been given and its adminis- 
tration should cease or the dose be reduced 
to about two-thirds of what was being given 
when the puffiness of the eyes and diarrhoea 
appeared. 

Should poisoning occur from the accidental 
swallowing of an overdose of Arsenic give an 
emetic. When the stomach is empty or be- 
fore, if the emetic acts at all slow, administer 
Ferric Hydrate and Magnesia in tablespoonful 
doses every fifteen minutes. Arsenic is very 
poisonous, and its administration should be 
according to directions. 

ARSENICUM ALBUM ( HOMOEOPATHIC) . 

Dose, 3x to 6x, i tablet given after meals or 
in water. 

Symptoms Calling for Arsenic. — In acute 
cases use the 3x tablet, and for chronic cases 
use the 5x or 6x tablet. 

Arsenic is indicated where there is great 
mental anxiety, restlessness and the patient 
cannot bear to be alone; starting and jerking 
of limbs when asleep, frontal headache, worse 
from heat and relieved by cold compresses ; 
watery corroding discharge from the nose, 
the gums are swollen and bleed easily, the face 



REMEDIES. 173 

is pale and drawn and neuralgic pains. Food is 
not tasted, gnawing and burning in the abdo- 
men, with a desire for water all the time ; 
drinks little and often ; there is cutting pain 
in the bowels, with dark, watery stools, that 
are followed by burning in the rectum and 
anus. 

Prostration is a marked symptom with the 
diarrhoea. Arsenic is good in kidney disease, 
associated with dropsy and puffiness of the face 
and limbs. Watery appearance of the skin, and, 
though the body is over-charged with water, 
there is a continual thirst. Dry, hacking 
cough and dryness of the chest before mid- 
night. The skin is dry and harsh, w,ith 
burning itching and biting pains. There may 
be eruptions that crust easily and burn and 
itch around the crusts. Ulcers that burn 
and have a watery, offensive discharge. 
Arsenic is good for the later stages of fevers, 
where there is blueness of the lips, dryness 
of the skin, dryness of mouth and cracking 
of lips, with thirst during the fever for oft 
repeated drinks, and diarrhoea of dark, of- 
fensive stools. 

The Arsenic patient is worse after mid- 
night, worse from cold or cold drinks, re- 
lieved by warmth and warm drinks and feels 
worse from lying still. 



174 MEDICAL. HANDBOOK. 



ALUM. 

Alum may be in large, colorless crystals 
or in a white powder. Alum is seldom used 
for internal medication. One to 2 teaspoon- 
fuls will usually cause vomiting. Five to 10 
grain doses may be used to check diarrhoea, 
but there are so many bad results from the 
internal use of Alum that it is seldom given. 
Irritation of the stomach and disturbed di- 
gestion is very apt to follow the internal use 
of the drug. 

Externally burnt Alum is often used as 
a powder for unhealthy wounds, ulcers, etc., 
etc. Alum cleanses the wound, stimulates 
healing and tends to remove exuberant granu- 
lation or proud flesh. 

Powdered Alum may be blown into the 
nose to stop nose bleed. A strong solution 
of 1 drachm or 1 teaspoonful to a pint of 
water may be drawn from the hand into the 
nose to stop nose bleed. The same solution 
may be used to bathe bleeding surfaces with 
or dressings may be applied to bleeding 
wounds that have been saturated in the Alum 
solution. 

ANTIMONIUM CRUDUM ( HOMOEOPATH ic) . 

Dose, 3x to 6x, 1 tablet every two hours. 
Symptoms Calling for the Drug.— Morose, 
thinking on the dark side of things. Is peev- 



REMEDIES. 175 

ish and sentimental. Does not want to be 
touched or looked at. Dizziness and headache, 
worse after eating. The abdomen feels dis- 
tended. Vomiting that is difficult to stop. 
An urgent call to evacuate the bowels, and 
the effort is attended with the escape of much 
gas and finally a small movement, followed 
by sticking, burning, deep-seated pain in the 
rectum. 

ARNICA MONTANA ( HOMOEOPATHIC) . 

Dose, to 3x, 1 to 5 tablets every two or 
three hours. 

Symptoms Calling for Arnica. — Sore, 
bruised sensation in any part of the body. 
Stitching pain in the head following bumps 
or blows to the head. Offensive taste in the 
mouth, with nausea after eating. Fermental 
diarrhoea, with slimy blood-streaked move- 
ments that are followed with much burning 
and tenesmus or griping. 

Soreness of the abdomen after labor. Sore- 
ness of the chest from coughing. Arnica is 
indicated in whooping-cough when children 
cry before coughing from the anticipation of 
pain. Soreness of the limbs, with fear of be- 
ing touched. The Arnica patient complains 
that the bed is too hard and he cannot find 
a soft place. Arnica tincture diluted with 
twice its volume of water makes a good lotion 
for bruises. Arnica should not be used where 



176 MEDICAI, HANDBOOK. 

the skin has been broken, but in its stead 
Hamamelis is to be preferred. For blood- 
spitting give 5 tablets of the tincture every 
hour. 

ANTISEPTICS. 

Antiseptics, as the name would imply, are 
drugs opposed to septic or putrefactive condi- 
tions. Antiseptics are used locally to cleanse 
infected areas or to prevent infection in newly 
injured structures. Internally these drugs 
are usually violent poisons, and for this rea- 
son should be well marked, labeled and 
guarded to prevent accidental administration 
and serious results. 

BICHLORIDE OF MERCURY OR CORROSIVE SUB- 
LIMATE. 

There is no other antiseptic so generally 
used as Corrosive Sublimate. It is a violent 
poison when taken internally. Should poison- 
ing occur from the accidental swallowing of 
Corrosive Sublimate the first thing to be done 
is to empty the stomach by a prompt emetic. 
Then give egg or egg albumen freely and oft 
repeated. The egg albumen combines with 
the free or unabsorbed poison and forms a 
non-poisonous compound. 

For the disinfection of surface wounds the 
Bichloride of Mercury may be used in the 
strength of 1 / 1000 - This is a good strength 



REMEDIES. 177 

for the disinfection of the hands prior to the 
handling of wounds or the performing of 
operations. For the continued use on wounds 
or for wet dressings the drug is best used in 
the strength of 1 / 2000 , as, if applied too strong, 
there is danger of vesication or blistering of 
the surface and perhaps absorption of too 
much of the drug. If vesication should occur 
discontinue the use of the Corrosive Subli- 
mate, and dust the vesicated part with some 
powder as Boracic Acid. The tablets are the 
best form in which to get the Bichloride of 
Mercury or Corrosive Sublimate for external 
use. 

N. B. — Always mark as poison and keep 
where no mistake can arise. 

CARBOLIC ACID. 

Carbolic Acid is very poisonous in large 
doses. As much as 2 grains may be taken in- 
ternally if diluted in water and cause no 
alarming symptoms. 

Poisoning may be produced by accidental 
swallowing of a watery solution or by the 
application of the acid in solution over ex- 
tended wound surfaces. 

The mouth and tongue have a burnt appear- 
ance where a strong solution has been inject- 
ed, and the breath has the characteristic odor 
of the drug. Where absorption from the sur- 
face of the body has produced poisoning the 

12 



178 MEDICAI, HANDBOOK. 

symptoms are dizziness, headache, weakness 
of the body and dark, cloudy urine. 

If accidental poisoning occur wash out the 
stomach with the stomach tube, using as a 
wash a solution of Epsom Salts in water, y 2 
ounce of Epsom Salts to the pint of water. 
Alcoholic drinks should also be given in the 
form of wine, brandy or whisky, for the alco- 
hol in the drinks stops the caustic action of 
the acid. It is not necessary to cause in- 
toxication. Oil is a very good thing to be 
given as soon as possible after the injection 
of the acid, as it dissolves the acid and pre- 
vents the deep burning of the drug. Epsom 
Salts in solution acts on Carbolic Acid and 
forms with it a non-poisonous substance. Egg 
albumen is also of service if given at once 
after the ingestion of the drug that the acid 
may act on the egg and prevent deep burning 
of the tissues. If the symptoms of chronic 
poisoning develop from the external use of 
Carbolic Acid stop its use in lotion or salve 
and the poisonous symptoms will disappear. 

For the hands and to cleanse offensive sores 
and ulcers Carbolic Acid in the strength of 
x / or 1 / 40 is an excellent wash. 

Externally Carbolic Acid is used as a 
caustic in strong solution and as a disin- 
fectant in the weaker solutions. Carbolic 
Acid combines with water in all strengths. 
The 1 per cent, solution is good for ulcers, 



REMEDIES. 179 

itch, tetter and itching areas in any part of 
the body, and for offensive arm pits and of- 
fensive feet. 

For offensive sore throat use 8 drops to the 
ounce of water as a gargle. For itching sur- 
faces 16 drops to the ounce of lard or vaseline, 
and apply as occasion demands. Also, as a 
soothing wash the following may be used : 

^. Carbolic Acid, 2 drachms. Alcohol. 
Glycerine aa, 1 ounce. Water, 1 pint. Use 
as often as occasion requires as a soothing 
wash. 

If a boil or carbuncle is to be lanced paint 
the line of incision with a strong solution 
and in a few moments the incision can be 
made without much pain being felt. 

For toothache apply a drop of the strong 
solution on a small pledget of cotton and 
cover with some more cotton, or keep the 
saliva from the tooth by a piece of cotton 
against the cheek. The Carbolic Acid if al- 
lowed to act is a very good remedy for tooth- 
ache. 

The cavities of carbuncles and deep, of- 
fensive ulcers are much benefited by being fre- 
quently cauterized to the very bottom with a 
strong solution. 

BELLADONNA. 

Dose. — Tincture of Belladonna, 3 to 10 
drops. Fluid Extract Belladonna, 1 to 2 



l8o MKDICAI, HANDBOOK. 

drops. Atropine Sulphate, 1 / 500 to 1 / 100 
grain. (N. B. — Part of a grain.) 

Internally, Belladonna in full doses pro- 
duces dryness of the throat, dilated pupils 
and increased frequency of the pulse; it pro- 
duces mental excitement and lessens all the 
secretions from mucous surfaces. 

Belladonna is used in convulsive seizures. 
Spasms of the throat, as in croup and whoop- 
ing cough. Incontinence of urine in children. 
As an adjunct to other drugs in constipation. 
As a local application in chilblains. Atropine 
in 1 / 150 part of a grain is used for the night- 
sweats of consumption, given at bed-time. 

In child-bed conditions where the mother 
cannot nurse the child 1 / 200 part of a grain 
twice a day will assist in drying up the milk. 
A Belladonna plaster is sometimes applied to 
the breast instead of giving Atropine. 

In salivation from overdoses of Mercury, 
1 / 200 part of a grain of Atropine Sulphate is 
beneficial to stop the excessive flow of saliva. 
Give two or three times a day. 

Never give Belladonna or Atropine Sul- 
phate longer than to get the dilated pupil and 
dry throat. Do not give Belladonna or 
Atropine to light complected persons, as they 
are very apt to be susceptible to the drug, and 
may break out in a red rash from its effects. 

Handle Belladonna and Atropine Sulphate 
with care, as they are strong drugs, and some 



REMEDIES. I8l 

persons are quite susceptible to even small 
doses. 

BELLADONNA (HOMCEOPATHIC) . 

Dose. — ix to 6x, i to 3 tablets every two 
to six hours. 

Indications Calling for Belladonna. — 
Flushed, bright red cheeks, injected eyes, 
throbbing headache, dilated pupils, squinting 
of the eyes, grinding of the teeth. Jumps 
from sleep and cries out and tries to escape. 
Delirium, tears at the clothing; clutches in the 
air and starts as if falling. May lapse into a 
stupor and awake with a scream and intense 
fear. Bores the head into the pillow. Hot 
skin and throbbing pulse. (Threatened con- 
vulsions of childhood should lead you to 
think of Belladonna.) In the ears there is 
shooting pain that may pass from ear to ear. 
Dry throat. Tongue red on edges and white 
in centre, with strawberry-like appearance of 
the tongue caused by the papillae of the tongue 
showing through the white coating. Bleeding 
of the nose, soreness of the throat, putrid 
taste in the mouth. Diarrhoea of green mucus 
with griping and bearing down. Turbid urine 
and frequent desire to urinate. Involuntary 
urination during sleep. Backache. Pain in the 
neck. In women the menses are too early and 
too profuse, with offensive discharge. When 
the flow is established the blood is bright red. 



l82 MEDICAL. HANDBOOK. 

Belladonna pains gradually increase and then 
suddenly disappear, to reappear in some other 
part of the body. The pain is worse on the 
right side. Jarring the bed makes the pain 
worse. Pain worse by gentle pressure, but 
firm pressure does not annoy the patient. 

Belladonna is of much service in the dis- 
eases of children and in fevers where there 
is a bright flushed face and delirium. 

BAPTISIA TINCTORIA (HOMOEOPATHIC) . 

Dose. — ix to 4x, i tablet every four hours. 

Symptoms Calling for Baptisia. — Dark, 
flushed and besotted appearance of face. Con- 
fusion of ideas. Stupid, goes to sleep when 
talking or forgets what he is saying. Stupefy- 
ing headache. Feels as if scattered about in 
the bed, and wants to get the parts together. 
Dark brown streak in the centre of the 
tongue. Fetid breath, offensive ulcers in the 
mouth. Offensive diarrhoea with colic and 
griping. Offensive perspiration. Chest seems 
full and is short of breath. Urine dark and 
offensive. Trembling of hands and feet. 

Baptisia is a good remedy in some forms of 
typhoid fever, and for fevers in general where 
there is a low exhausted condition. 

BISMUTH SUB NITRATE. 

Dose. — From 2 to 40 grains. Usual dose, 4 
grains for children; 10 grains for adults. 



REMEDIES. 183 

Bismuth Subnitrate is a white powder al- 
most tasteless, is permanent, or does not 
change if exposed to the air. Bismuth has an 
astringent and antiseptic action. Bismuth is a 
very valuable remedy for acidity of the 
stomach, catarrh of the stomach, ulcer of the 
stomach, and acute indigestion with vomit- 
ing. 

In catarrhal diarrhoea where the bowels are 
empty or have been emptied by a purge, Bis- 
muth is antiseptic and sedative to the intes- 
tinal mucous membrane. 

After taking Bismuth the stool becomes 
dark or greenish from the decomposition of 
the drug in the intestines. 

Locally, Bismuth and Starch in equal parts 
make a good healing powder for ulcers and 
bed-sores. One drachm of Bismuth to an 
ounce of vaseline makes a good healing salve. 

For ulcer and catarrh of the stomach give 
10 grains of Bismuth one-half hour before 
the meal. For diarrhoea give 10 to 15 grains 
of Bismuth two hours after the meal, that 
the Bismuth may not lay in the stomach while 
digestion is going on. After two hours the 
food passes from the stomach. If milk is the 
food, give the drug one hour after feeding, in 
order that, as the food leaves the stomach, the 
Bismuth will reach the intestines in a direct 
manner. For diarrhoea of infants give 3 or 4 
grains of Bismuth, one hour after feeding. 



184 MKDICAI, HANDBOOK. 

For acidity of the stomach give any time 
when required. For the diarrhoea of adults 
give 10 grains, two hours after meals. If 
given with the meal the drug lies in the 
stomach during digestion; therefore, give 
some time after eating. 

BRYONIA ALBA ( HOMOEOPATHIC ) . 

Dose. — ix to 6x, one tablet four times a day. 

Indications for Bryonia. — Fullness of the 
head, splitting headache, irritable. Wants 
things and when they are offered refuses 
them. Mouth parched and dry. Tongue 
coated dark brown and cracked. Great thirst for 
much water at a time, at long intervals. Weight 
in the stomach after meals. Sensation of a 
lump in the stomach. Stitches in the liver. 
Constipation, dry, dark, lumpy stool. Ten- 
derness of the abdomen. Urine scant and red 
in color. Menses in women too early, too 
profuse, and attended with stitching pain in 
the abdomen and legs. Rheumatic swelling 
of the joints, starting on going to sleep. Dry 
cough worse at night when in bed. Stitch- 
like pain in the chest, the abdomen and in the 
joints. Bryonia is good in typhoid fever 
where the limbs are sore and motion makes 
all the pains worse. Severe frontal head- 
ache. Delirium where the patient wants to go 
home or dreams of business. Nose-bleed is 
also present in fevers where Bryonia is indi- 



REMEDIES. 185 

cated. The Bryonia patient is worse in the 
morning and worse from motion. 

BETA NAPHTOL BISMUTH OR ORPHOL. 

Orphol is a light-brown powder having no 
odor or taste. 

Orphol, y 2 drachm to 1 ounce of lard or 
vaseline, is one of the best, quickest and least 
irritating ointments for the cure of the itch. 
One-half drachm to 1 ounce of vaseline is 
quite sufficient where the surface involved is 
large. 

Apply the ointment daily for five or six 
days, then take a bath or wash the affected 
area. 

BERBERIS VULGARIS (HOMCEOPATHIC) . 

Dose. — 2x to 6x, 1 tablet three times a day. 

Indications for Berberis. — Sticking pain In 
the region of the liver or under the ribs of 
the right side of the chest. Sticking pain in 
the kidney, which may extend from the kid- 
ney to the bladder. Burning, cutting pain in 
the bladder worse on urinating and extending 
into the urinary passage. Red sediment in the 
urine. Biliary colic, liver spots. Is a good 
remedy for women who have pain in the right 
side. Liver spots (dark brown areas on the 
face or other parts of the body). Such 
women have headache, pain in the back that 
extends into the legs, and pain on urinating 



l86 MEDICAL HANDBOOK. 

that comes from the bladder and extends 
along the urinary passages. 

COLOCYNTHIS ( HOMOEOPATHIC) . 

Dose. — Q to 3x, i tablet every hour until re- 
lieved. 

Indications for Colocynth. — Violent neu- 
ralgia of the head and face, worse on the 
right side. Very irritable. Severe colicky 
pains in the abdomen, worse around the navel. 
Sore feeling of the bowels. Colic relieved by 
bending forward and by pressure. Green or 
bloody diarrhoea, diarrhoea after emotion or 
vexation. Colic and diarrhoea always asso- 
ciated. Ovarian colic at menstrual period re- 
lieved by pressure. Sciatica or pain extending 
from the hips to the thighs and feet. Cramp- 
like pain in any part of the body as if the part 
were in a vise. 

CATHARTICS. 

Cathartics are drugs that will move the 
bowels by their action on the muscular walls 
of the intestines, or by causing an increased 
amount of fluid in the intestines, excited by 
the action of the drug on the intestinal 
mucous membrane. Some cathartics act on 
the large intestine and some on the small. The 
object desired should direct in the selection of 
the cathartic. 



REMEDIES. 187 

U. S. P. CATHARTIC VEGETABLE PILLS. 

The U. S. P. Veg. Cathartic Pills are a com- 
bination of drugs that act on all parts of the 
intestine, causing an increase in the watery 
secretion of the bowel, and an increase in the 
onward movement of the intestines. They are 
a very efficacious remedy for the emptying of 
the bowel. 

Dose. — One to two pills, and repeat in six 
hours if no movement has occurred. 

CASTOR OIL. 

Dose. — One teaspoonful for an infant and 
^ to 1 ounce for adults. 

Castor oil is a safe and prompt cathartic, 
moving the bowels by its irritant action on the 
muscular coats of the intestines. The time re- 
quired to cause a movement is from four to 
six hours. Following the use of Castor oil 
there is usually a reactive quiescense of the 
muscular coats of the intestines and a ten- 
dency to constipation ; therefore, Castor oil is 
to be given for the simple emptying of the 
bowel and not as a remedy for constipation. 
Where there is acute indigestion and the 
bowels needs emptying there is no better 
remedy. In summer complaint or in diar- 
rhoea that results from improper feeding, one 
dose of Castor oil is very beneficial in assist- 
ing the intestines to rid themselves of their 



l88 MEDICAL HANDBOOK. 

obnoxious burden. Following Castor oil the 
Subnitrate of Bismuth in fairly large doses 
often affords prompt relief to the drain of 
diarrhoea. 

CROTON OIL. 

Dose. — One to 2 drops, and repeat in two 
hours if the bowels have not moved. 

Croton oil is a very prompt cathartic acting 
usually within two hours, and often within 
one-half hour. The oil is very irritant to the 
stomach and bowels, and produces its prompt 
results by causing the muscular coats of the 
bowel to act energetically. Croton oil should 
not be given where there is inflammation or 
disease of the intestines, as it then may do 
much harm by its irritant action. 

Do not give in larger doses than one to 
tw r o drops. It is given best on sugar. 

Locally. — Croton oil will blister if painted 
on the skin. Applied to warts daily it will 
cause their disappearance. 

CASCARA SAGRADA. 

Dose. — From 10 to 60 drops. 

Give after meals or at bedtime. Cascara 
Sagrada Aromatica is the most pleasant form 
to take. 

Cascara causes an increased action of the 
muscular coats of the bowels and may thus 
cause some griping. 



REMEDIES. 189 

Where there is atony or inactivity of the 
bowel, as is often the case in elderly people, 
Cascara in small doses after meals or at bed- 
time will assist much in establishing a regular 
habit. The habit of moving the bowels at a 
regular hour in the day is of much importance, 
and should be acquired by all. Constipation 
is almost a confession of laziness, and the 
taking of cathartics is only a means of tem- 
porizing, and, if persisted in, makes matters 
worse. 

CALCAREA CARBONICA ( HOMOEOPATHIC ) . 

Dose. — ix to 3x, 3 tablets three times a day. 

Indications for Calcarea carb. — Sees ob- 
jects on closing eyes, but the objects dis- 
appear on opening the eyes. Acidity of the 
stomach and vomiting. Great appetite early 
in the morning. Sour, offensive stools of un- 
digested food. Dry cough at night. Expec- 
toration in the day. Any wound of the skin 
heals poorly. 

In light-complected women Calcarea carb. 
is good where the menses come too early, last 
too long and are too profuse. 

Calcarea carb. is the remedy for fat, fair, 
flabby children who have a large head, sweat 
easily about the head, are stupid and sluggish 
of thought, have a large abdomen, are sub- 
ject to sour vomiting and sour diarrhoea, have 
cold hands and feet, swollen and enlarged 



I90 MEDICAL HANDBOOK. 

glands. Such a child may be thin or run 
down in flesh, though the natural tendency is 
is be fat. Children with scrofulous taints, and 
those of consumptive parents are often much 
benefited by the use of this drug. 

CHAMOMILLA ( HOMOEOPATHIC) . 

Dose. — Q to ix, i tablet every two hours. 

Chamomilla blossoms can be had at any 
drug store, and from the blossoms a very 
soothing tea is made for infants. Steep a 
teaspoonful of the blossoms in a small cup of 
water, strain, add sugar and give to the child 
as occasion may demand. There is no danger 
in giving Chamomile tea to cross babies, on 
whom it has a soothing action. 

Indications for Chamomilla. — There is 
great restlessness and violent temper. Cries 
for things and then refuses them when they 
are offered. Child wants to be carried from 
one place to another. Throbbing headache 
with perspiration of the head. Twitching of 
the eyelids. Toothache, sore throat and a 
bitter taste in the mouth. Vomiting of bile. 
Stools hot and burn, smell bad and look like 
chopped spinach and egg. Hoarseness and a 
cough that is dry even though there is rattling 
of mucus in the chest. Cramp-like pains of 
the hands and feet. Clinching of the hands, 
and pain in the calves of the legs. Starts 
during sleep with a sudden cry. Face hot and 



REMEDIES. 191 

the breath is hot, while the hands and feet are 
cold. Yellow appearance of the skin. 

In men nocturnal emissions, pain in the 
back and weight in the genitals. 

In women the menses are preceded by 
leucorrhcea, and the flow is profuse, dark and 
clotted, with pain in the back and legs. 

ACTEA RACEMOSA (HOMCEOPATHIC) . 
CIMICIFUGA IS THE SAME DRUG. 

Dose. — to 3X, 2 tablets every three hours. 

Indications for Cimicifuga or Actea 
racemosa. — Gloomy state of the mind, wishes 
solitude. Head feels too large and there is 
severe frontal headache. The top of the head 
feels as if it would fly off. Neuralgia of the 
scalp. Aching of the eyeballs. Fullness of the 
throat and hawking up of mucus. 

In women there is a tenderness of the 
uterine region. The menses come too early, 
are dark and clotted, and there is a tender- 
ness of the abdominal organs. The patient 
may weep from anxiety. There is leucorrhcea, 
or what is commonly termed the "whites," 
with a heavy sensation in the uterus. Stop- 
page of the flow from cold or emotional ex- 
citement. After-pains during the child-bed 
period. Stiffness of the neck with pain on 
motion. Pain in back and hips. Pain from 
one hip to the other through the pelvic organs. 

Cimicifuga is one of the best remedies for 



I92 MEDICAI, HANDBOOK. 

stoppage of the flow. Painful menstruation. 
Gloomy depression and headache during the 
flow. For delayed menstruation. For hys- 
terical symptoms with numbness of the body 
and nervousness from exertion. For the many 
and varied nervous, mental and physical 
phenomena of the change of life. 

TR. CIMICIFUGA ( ALLOPATHIC) . 

In regular medicine Cimicif uga is given for 
the nervous conditions of the change of life. 
Sudden stoppage of the flow. For absence 
of the flow, and where the flow comes between 
the proper time. Hysteria, mental unrest after 
confinement and St. Vitus' Dance. 

Dose. — Ten to 30 drops of the tincture 
three times a day. 

SULPHATE OF COPPER. ELUE VITRIOL. 

Internally, the Sulphate of Copper is not 
much used. In case of Phosphorus poisoning, 
from 4 to 10 grains may be used as an emetic, 
also using other means to hasten vomiting. 
With Phosphorus the Sulphate of Copper 
forms a non-poisonous compound. If, when 
given as an emetic, the drug should not cause 
vomiting, then give 10 grains of Carbonate of 
Soda and an egg or two, and some milk to 
counteract the drug's action. If Phosphorus 
has been taken, do not rely altogether on 
this drug, but give Ipecac or Apomorphine in 
addition. 



REMEDIES. 193 

Externally, the Sulphate of Copper is a 
very good remedy for sore eyes and snow- 
blindness. One and one-half grains to 2 
drachms of water, or a 1 per cent, solution, is 
a very good remedy for sore eyes. For 
gonorrhoea or purulent discharges from the 
genital tract much benefit is derived from the 
washing or irrigating of these organs with a 
solution of 15 to 30 grains to the pint of 
water. 

CAFFEINE CITRAS. CITRATE OF CAFFEINE. 

Caffeine Citrate is a white, inodorous 
powder. The taste is acid and bitter. This is 
the active principle of coffee. 

The dose is from 2 to 5 grains. 

Used with Acetanilid it makes an excellent 
headache powder. 

Caffeine Citras, '20 grains. Acetanilid, 30 
grains. Mix, and make ten powders. 

Take one for headache when occasion may 
require. 

CHINA (H0M030PATHIC). 

Dose. — to 6x, 1 tablet every three to six 
hours. 

Indications for China. — Discouraged, in- 
disposed, neuralgia over the eyes and of the 
upper jaw. Throbbing headache, burning in the 
eyes. Roaring in the ears, frequent nose-bleed, 
dry lips and mouth, dry tongue, belching, poor 

13 



194 MEDICAI, HANDBOOK. 

digestion, fullness after eating, constipated, 
difficult stools. At times diarrhoea that is 
painless and passed with apparent difficulty. 
Urine dark and scant. 

In women the menses are early and dark, 
clotted. Menses preceded by leucorrhcea and 
pressure in the abdomen. 

Nocturnal emissions with debility in men. 

China is to be thought of in fevers where the 
pulse is small and rapid. Chill of the body 
preceded by thirst. Distress of the chest and 
an inclination to take a deep breath. The pa- 
tient that needs China is worse every other 
day or at repeated periods. Has neuralgia of 
the forehead, upper cheek-bone and of the 
teeth. 

China is of value where there is depression 
from exhaustion, or where there are excessive 
discharges from the body of any nature, and 
where there has been loss of blood following 
an accident. 

DOSE AND ADMINISTRATION OF DRUGS. 

By a drug is meant a simple or compound 
substance, which, when introduced into the 
system is capable of producing local or con- 
stitutional symptoms peculiar to that drug. 

Drugs may be either derived from the vege- 
table kingdom or from the mineral or earthy 
elements, in the natural state or as the result 
of chemical action. 



DOSE AND ADMINISTRATION. I.95 

Drugs are given in some substance that is 
used to carry and keep them in solution or in 
dilution that the size and force of the drug 
may be regulated and brought to bear on the 
proper diseased tissues or assimilative surfaces. 
Such a drug carrier is called a vehicle. The 
common substances used as vehicles are water, 
syrup, sugar of milk and oils. 

Drugs may be given by the mouth, per 
rectum or by hypodermic injection, and by in- 
unctions. 

Drugs given by the mouth usually are ab- 
sorbed and taken into the circulation from the 
stomach. Drugs given on a full stomach are 
slowly absorbed, on an empty stomach usually 
rapidly absorbed. Where drugs are intended 
to reach the bowels as Bismuth in diarrhoea, 
they are best given about two hours after a 
meal, that they may pass with the food 
into the intestines, and not wait the delay of 
digestion in the stomach. 

Drugs given per rectum are best given in 
suppository or in enemata. The hypodermic 
injection of drugs is best accomplished by 
using regularly prepared hypodermic tablets. 
The injection should be on the arm, thigh or 
calf of the leg. Avoid large veins and vascu- 
lar areas, for it would be dangerous to inject 
a drug directly into the circulation. Medi- 
cated ointments, as a rule, are applied with 
friction to the part with which it is desired to 
bring the drug in contact. 



I96 MEDICAI, HANDBOOK. 

Drugs having opposite actions should not be 
given at the same time, as they may counter- 
act each other in effect, and, if chemically op- 
posite, they may produce a new and unex- 
pected substance as the result. 

In books, as a rule, the smallest dose that 
will produce the full effects of the drug is 
given, and also the largest dose that is safe 
to administer to a strong man at one time, is 
also given. The age, the vital powers ami the 
condition of the patient with regards to the 
effect of drugs already in the system must 
determine the size of the dose. To find the 
dose for a child this (Young's) rule is a good 
guide. Use the age of the child as the 
numerator of the fraction, and the age of the 
child plus 12 as the denominator, and reduce 
the fraction, the result will be the approximate 
dose for the child. Example : 

2 years 1 



2+12 7 

the dose of an adult. 

Variations of This Rule. — Children are 
very susceptible to the stronger narcotics, such 
as Opium or Laudanum, and the dose must be 
much smaller than this rule would indicate. 
According to this rule a child of 6 months 
would get about one-sixth the dose of Lauda- 
num for an adult, when, in fact, he can stand 
but about one-twentieth the dose. So also a 



DOSK AND ADMINISTRATION. I97 

child will not be affected in a purgative man- 
ner by one-sixth the dose of Castor Oil, but 
requires more of the purgative drugs. Then 
give children much less than this rule indi- 
cates of the narcotics and opiates, and con- 
siderably more than the dose indicated by 
this rule of the purgatives. 

Women take smaller doses than strong 
men. Some people are very susceptible to cer- 
tain drugs, and the use of such drugs must be 
with caution where the patient is suscepti- 
ble, as, for instance, Belladonna and light- 
haired, light-complected women. 

Above all things consider an unlabeled drug 
rank poison and you will be saved trouble and 
sorrow. 

In giving homoeopathic drugs according to 
the indications there should be at least three 
marked symptoms calling for the drug. If 
two or three drugs have the same symptoms 
indicated in disease take the one that has the 
most symptoms indicating the drug. 

indicates the homoeopathic tincture, x in- 
dicates 1 / 10 as much as is found in the tinct- 
ure. 2x indicates 1 / as much as is found in 
the x, or 1 / 100 part as much of the drug- as is 
found in the tincture. For acute conditions it 
is best to give the (tincture) or the lower 
dilutions, as is represented by the smaller 
figure in front of the x. For chronic conditions, 
where the drug is to be given repeatedly for 



I98 MEDICAL HANDBOOK. 

days, the higher dilutions, or weaker prepara- 
tions as represented by the larger number in 
front of the x, should be given. It is not neces- 
sary that all the indications given under any 
drug should be present before that drug is 
given. Three prominent symptoms should be 
present out of all given to make the selection 
a good one. 

DULCAMARA (HOMOEOPATHIC) . 

Dose. — ix to 6x, 1 tablet every three hours. 

Indications for Dulcamara. — Swelling of 
the glands, eruption resembling hives, diar- 
rhoea, worse in damp, cold weather. 

In women an irritable disposition, sup- 
pressed menses ; the coming of the flow is al- 
ways preceded by the appearance of a rash on 
the skin of the body. 

Dulcamara is good for rheumatism or diar- 
rhoea, made worse by damp, cold weather, or 
the suppression of the flow from the same 
cause. Affections of the skin, mucous mem- 
branes and muscles that are made worse in 
damp, cold weather will usually be benefited 
by Dulcamara. 

DIGITALIS. 

Dose. — Tr. Digitalis, 2 to 20 drops. Fluid 
Extract Digitalis, 1 to 2 drops. 

Digitalis slows the pulse and raises the 
blood pressure. There is an accumulative 



EMETICS. 199 

action of Digitalis that may, when least ex- 
pected, after the drug has been given for 
some time, produce alarming symptoms. 

Digitalis is indicated where the pulse is 
rapid and soft, when there is shortness of 
breath on exertion, palpitation of the heart 
from emotional excitement, poor circulation, 
with cold hands and cold feet. Three to 5 
drops of the Tincture of Digitalis will often 
relieve many of these symptoms. Give twice 
or three times a day for not more than a 
week at a time. 

EMETICS. 

Emetics are drugs or substances used to 
produce vomiting. 

Vomiting may be produced by a drug that 
acts on the brain center, or by drugs that 
irritate the stomach or intestines and act 
through the nervous system to cause the 
empt}dng of the stomach. 

Drugs that act on the brain centers are 
the most prompt and reliable. 

I£. Apomorphine hydrochlorate, 1 / 10 part 
of a grain. 

Given preferably hypodermically ; but will 
act if given internally by the mouth. Repeat 
the dose in ten minutes if by the first dose 
emesis is not produced. 

To cause vomiting by irritation of the 
nerves of the stomach. 



200 MEDICAL HANDBOOK. 

Give 

J£. Syrup of Ipecac, from 15 drops to 2 tea- 
spoonfuls, according to the size of the patient. 
Repeat the dose in fifteen minutes if neces- 
sary. 

I£. Brown Mustard, 1 teaspoonful ; stir 
well into a cup of warm water and drink. 
Repeat in fifteen minutes if necessary. 

The stomach may be emptied by having 
the patient drink a cup of tepid water, and 
then irritate the throat with the finger or a 
feather. 

ENEMATA. 

An enemata may be administered to relieve 
constipation, to check haemorrhage from the 
lower bowel, to supply food when the 
stomach cannot retain food and to administer 
drugs and to relieve thirst when water can- 
not be given by the mouth. An enemata for 
an infant is about 1 ounce; for a child of two 
years, 2 or 3 ounces, and so on, a little more 
than an ounce to the year. Adults should re- 
ceive from 1 to 2 pints, and where it is de- 
sired to reach the upper bowel more must be 
given. In the giving of an enema the first 
thing is the value of time. Rapid distension 
of the bowel usually calls for an immediate 
evacuation before the object sought can be 
secured. Have the patient lie on the left side 
or on the back, elevate the hips a little that 



ENEMATA. 20I 

gravity may assist the retaining of the injec- 
tion. Inject slowly and if necessary support 
the parts that the fluid be retained. By stop- 
ping the stream the bowel has time to re- 
gain itself and the fluid to pass up further, 
relieving the desire to stool, then more can 
be given. An enema for the relief of con- 
stipation is best if retained about fifteen min- 
utes. Medicated enemas are small and fully 
explained by the physician. Feeding or nutri- 
tive enemas are used when the stomach for 
some reason cannot retain food. The amount 
is always small ; for an adult, say, Y^ of a pint, 
and fo ra child a smaller amount in propor- 
tion to its age. Nutritive enemata may be of 
milk, beef tea, of broth or gruel, or enemata 
of eggs and milk. To all nutritive enemata 
should be added pepsin, i grain to the ounce, 
to digest the food since the lower bowel can- 
not digest well. From i to 4 teaspoonfuls of 
brandy or whisky can be added to the nutri- 
tive enema as a stimulant if desired and or- 
dered by the physician. Wash out the bowel 
before giving a nutritive enema, and again 
before giving a second feeding injection. 

Nutritive enemata should not be given 
oftener than once in three hours. Injections 
to quench thirst are of pure water and larger 
than nutritive enemata, or about y 2 to 1 pint 
should be given. All enematas should be of 
a temperature of from 80 to 100 degrees F. 



202 MKDICAI, HANDBOOK. 

unless ordered cold, as is sometimes done, to 
stop haemorrhage from piles. 

FERRUM OR IRON. 

Dose. — Blaud's Iron pills, i pill after meals. 

The action of Iron in the system is to 
cause those suffering from a want of the red 
blood corpuscles to become more rich in this 
particular element of the blood. 

Anaemic or white, bloodless persons often 
rapidly improve under the influence of Iron. 

Women and girls, who do not menstruate 
because the system has no blood to spare, 
menstruate when the system has become en- 
riched and the blood is back to the normal 
standard as a result of taking Iron. Iron is 
not the only remedy for anaemia, but it is a 
valuable remedy. 

FERRUM METALLICUM (HOMCEOPATHIC) . 

Dose. — ix to 6x, i tablet three times a day. 

Indications for Ferrum. — The Ferrum pa- 
tient is dizzy on descending a hill or crossing 
water. The face is pale and may be yellow- 
spotted. Excitement causes flushes of the 
face. The stomach feels as if pressed upon 
after eating. There is belching of sour undigest- 
ed food. The patient may vomit the food in al- 
most the same condition as it was when eaten. 
In the intestines the indigestion is marked and 
the bowel movements may contain the food 
unacted upon. In the morning there is a 



FOOD FOR THE) SICK. 203 

spasmodic cough, caused by tough mucus. In 
men there may be impotence and nocturnal 
emissions. In women the flow may be pre- 
ceded by strings of mucus or a milky leucor- 
rhcea. Headache and ringing in the ears. The 
flow is too profuse, too often and lasts too 
long. 

The Ferrum patient is better from walk- 
ing around and is subject to flushes of the 
face as a result of excitement or from pain. 

FOOD FOR THE SICK. 

There is often much misunderstanding be- 
tween friends and physicians as to what and 
why foods should be given as they are. To 
force onto the stomach foods that it cannot 
handle is not to be desired. Sick people can- 
not digest, as when well, and the giving of 
food should be regulated that the most 
strength be secured with as little taxation of 
the digestive organs as is possible from the 
food given. 

BARLEY SOUP. 

Wash 1 tablespoonful of barley in cold 
water, cover with boiling water, let boil up 
once and drain off. Cover again with boil- 
ing water and boil slowly for two hours, drain 
and add to meat broth or stock, and let stand 
on back of stove for ten minutes, salt to taste 
and serve. The stock can be made from game 



204 MEDICAL. HANDBOOK. 

or beef. Do not add much spice to the beef 
or game in making the stock. Use i pint 
of stock for the barley indicated above. 

BARLEY WATER. 

Stir into i pint of cold water i teaspoon- 
ful of ground barley and a pinch of salt, boil 
for y 2 hour, strain and keep in a cool place 
ready for use. 

RICE SOUP. 

Wash i tablespoonful of rice in cold water. 
Boil slowly in i pint of water for thirty min- 
utes, drain and add to i pint of rich meat 
broth the same as with barley. 

PEPTONIZED MILK. 

Stir 5 grains of pepsin and 15 grains of 
soda bicarbonate (baking soda) in 4 ounces 
of water, mix well with a pint of milk and let 
stand in a warm place for J / 2 hour, then bring 
to a boil for two or three minutes and place 
on ice until used, sweeten to taste. 

This may be used in nutritive enemata, in 
milk punches and where milk is used as food. 

MILK PUNCH. 

To a half pint of fresh milk add 2 teaspoon- 
fuls of sugar and add from 4 to 8 teaspoon- 
fuls of brandy, stir well. If condensed milk is 
used no sugar need be added. 



FOOD FOR THE SICK. 205 



EGG-NOG. 

To a well beaten tgg add a teaspoonful of 
sugar and 4 teaspoonfuls of whisky or brandy 
and add to Ya cup of fresh milk. (If con- 
densed milk is used omit the sugar.) 

TEA. 

Use to each cup of tea ( T /2 pint) a teaspoon- 
ful of tea, put tea in the pot and add the boil- 
ing water, set back where it will keep hot, 
but not boil. 

COFFEE. 

To each pint of coffee use 2 heaping tea- 
spoonfuls of coffee finely ground, mix the 
ground coffee in a little cold water, place 
in the pot and pour on it a pint of boiling 
water. Let boil up twice and add a little cold 
water and set back where it will remain hot, 
but not boil, for five minutes more while it 
settles. Put cream and sugar in the cup and 
then pour on the coffee. 

IN THE FEEDING OF THE SICK. 

Avoid things prepared in the frying pan, 
have each article well done before serving. 
Feed the sick regularly, but not too much at 
one time. Do not give acid fruits or foods 
with milk, starches, puddings and gruels. 



206 MKDICAI, HANDBOOK. 

Acid fruits or foods go with meat and the 
albumens, and not with the starches. 

POTATOES. 

Baked potatoes, boiled potatoes and mash- 
ed potatoes are all good articles of diet for 
the sick. 



EGG CUSTARD. 

Beat i egg well and add a teaspoonful of 
sugar and a little salt, and add this to i cup 
of scalded milk, stirring well until thick; the 
milk should be in a receptacle that is resting 
in boiling water or a farina cooker. Pour in 
small dishes and set aside and serve cold. 

GELATINE. 

Gelatine is a very agreeable and nutritious 
food and should like beef extract be kept on 
hand for sickness. Knox's gelatine is as good 
as any. All have recipes on each package, 
which, if followed, makes delicious gelatine. 

BEEF TEA. 

The extract in jars is very reliable and 
good to have in the house, but the freshly 
prepared tea is often preferable. Take a 
pound of fresh, lean beef, slice thin and 
pound well or grind through a sausage mill. 



FOOD FOR THE SICK. 207 

place in a pint of cold water and bring slowly 
to a boil, skim off, strain, season with a little 
salt and serve. 

CHICKEN, GAME OR MUTTON BROTH. 

To a pound of the game or meat cut in 
small pieces add a quart of cold water, bring 
slowly to a boil and let simmer for two hours 
in a closely covered kettle, strain through a 
sieve and let stand a few moments, skim off 
the fat, salt to taste and serve. A teaspoon- 
ful of rice can well be added to each pound 
of meat if desired, as well as a little pepper. 

MILK. 

Fresh milk is often used as food for the 
sick; sterilized milk is very much to be de- 
sired. Milk may be sterilized by placing the 
bottle in a steam sterilizer for a sufficient time 
to thoroughly cook the milk, or in a pan of 
boiling water. Milk should boil or steam until 
brought to the boiling temperature for several 
minutes. 

RICE PUDDING. 

Wash Y^ cup of rice in cold water, add i 
quart of cold milk, sugar to taste, and add l / 2 
teaspoonful of salt, grate a little nutmeg over 
it, and bake slowly for three hours in a pud- 
ding pan ; stir occasionally while baking. 



208 MEDICAL HANDBOOK. 



FARINA GRUEL. 

Sprinkle slowly i teaspoonful of farina into 
a pint of boiling milk, stir well to prevent 
lumps ; boil slowly for y 2 hour ; salt to taste 
and serve. 

OATMEAL GRUEL WITH MILK. 

Soak y 2 pint of oatmeal in a quart of water 
for ten hours ; if dry add a little more water 
and boil for an hour, strain and add I pint 
of boiling milk ; bring this to a boil and salt to 
taste. 

BOILED FLOUR GRUEL. 

Moisten I pint of flour with enough water to 
make it into a ball and tie it up in a piece of 
muslin, and then moisten the cloth on the out- 
side and paint with flour, then boil the ball of 
flour ten hours, and remove the cloth and dry 
the flour ball in a slow oven for eighteen or ten 
hours. When desired to make gruel, grate 
from the ball two teaspoonfuls of this boiled 
flour, mix to a paste in cold water, and stir 
into y 2 pint of boiling milk, boil slowly for 
three or four minutes and serve. If con- 
densed milk is used no sweetening is needed, 
but if fresh milk, sweeten to taste. 

CREAM TOAST. 

Use two slices of stale bread, dry wel] in 



REMEDIES. 209 

oven, toast to even brown over fire; place in 
dish and pour over it boiling water; let stand 
a minute, drain off, and butter and salt a little, 
and pour over it a little fresh cream; place 
again in the oven for a few minutes until hot 
and serve hot. 

PLAIN TOAST. 

Plain toast is made as directed above, only 
no water is poured over it. The toast is but- 
tered and salted and served dry while hot. 

GELSEMIUM SEMPERVIRENS (HOMCEOPATHIC) . 

Dose. — 6 to 3x, 2 tablets every two to four 
hours. 

Indications for Gelsemium. — Confusion of 
the mind, fullness of the head, frontal head- 
ache and hot face, chilliness of the body, the 
eyes are heavy and there is drooping of the 
eyelids, dimness of vision, with aversion to 
light; dry lips, hot tongue and fullness of the 
throat, running of the nose, sour belching, 
diarrhoea from excitement or emotion, pain in 
the chest and in the region of the heart, lassi- 
tude, profuse urination of clear urine. In men 
involuntary emissions, followed by debility 
and low spirits. In women suppressed menses, 
with headache. Labor-like pains during preg- 
nancy. A good remedy early in colds, with 
running of the nose. 



14 



210 MEDICAL HANDBOOK. 

GRAPHITES (HOMOEOPATHIC). 

Dose. — ix to 6x, i tablet three times a day. 

Indications for Graphites.* — Feeling as if 
intoxicated, rheumatic pains of half of the 
head, extending into the teeth; sound in the 
ears as of the report of a gun, eruption back of 
the ears, soreness of the eyes and aversion to 
light, nausea after eating, with distended feel- 
ing of the abdomen; constipation associated 
with shreds of mucus. In women morning 
sickness during menstruation, pain in the left 
ovary, suppression of the menses, with heavi- 
ness and weight of the limbs ; leucorrhcea that 
is thin and white and excoriates the vagina, 
disposition to delayed menstruation, symp- 
toms worse in the evening. 

GUAIACUM (HOMOEOPATHIC). 

Dose. — to 3x, 2 tablets every three to six 
hours. 

Indications for Guaiacum. — Sore throat, 
with little constitutional symptoms ; right side 
of the throat most affected, tonsils enlarged, 
especially the right tonsil; stinging, sticking 
pain in the throat, worse in a warm room, 
veins of the throat are enlarged, threatened 
quinsy, rheumatism of the joints, with dis- 
tension and distorsion of the joint. 

Vague growing pains in children. 



REMEDIES. 211 

HEPAR SULPHUR (HOMCEOPATHIC) . 

Dose. — ix to 6x, i or 2 tablets three times 
a day. 

Indications for Hepar sulphur. — Sad- 
ness and dejected spirits, anguish of mind, 
dizziness on riding in the cars or from shaking 
the head, pain in the eyes, things look too 
large, purulent inflammation of the eyes and 
ears, pain in the bones of the head and face, 
soreness and roughness of the throat, with 
pain extending into the ears on swallowing; 
longing for acid foods, distension of the 
stomach, stitches in the liver, swelling of the 
glands of the neck and groin, sour undigest- 
ed diarrhoea, burning on urinating, dark hot 
urine excoriating the urinary passage- In 
women between the menses there are dis- 
charges of bloody mucus, dry, hoarse cough, 
loss of voice, rattling in the chest in the 
morning, wheezing during the act of breath- 
ing. Hepar sulphur is the prime remedy 
where suppuration is threatened, either in the 
throat, the eyes or ears, or on the surface of 
the body, as in abscesses, ulcers or boils. Give 
the 4x or 6x to prevent suppuration and the 
ix to hasten the breaking down and discharg- 
ing of pus, as is sometimes wished in boils 
and quinsy. Give 1 or 2 tablets three times a 
day, or, if the case is urgent, every three 
hours. 



212 MEDICAL HANDBOOK. 

Ferrum phosphoricum should be mentioned- 
ed along with Hepar sulphur, as Ferrum 
phos. ix to 3x every three hours is a very 
good remedy to ward off inflammation when 
after injury or exposure inflammation is ex- 
pected but is not yet present. 

HYDRASTIS CANADENSIS ( HOMCEOPATHIc) . 

Dose. — to 3x, i to 3 tablets three or four 
times a day. 

Indications for Hydrastis. — Feeling as if 
intoxicated, irritable, forgetful, dull frontal 
headache, eczema around the roots of the 
hairs of the forehead, watery excoriating 
nasal discharge, sneezing, tenacious discharge 
into the throat from the nose, hawking, sore 
spots on the tongue and cheek, swollen tongue, 
showing the imprints of the teeth ; tongue 
coated gray or yellowish, all-gone feeling in 
the stomach, with dull, aching pain ; consti- 
pated, stools covered with mucus, at times 
diarrhoea of a chronic character and there is 
an associated pain in the lower bowel, with 
scalding and burning after movement ; urine 
dark and has a stringy sediment, dull aching 
in the bladder and kidneys ; the cough of 
Hydrastis is dry and harsh, with rawness and 
soreness of the chest ; tickling in the throat 
that may make the eyes water, thick, tenacious 
yellow-colored sputa. In men thick, yellow, 
painless discharge from the penis. In wo- 



REMEDIES. 213 

men thick, stringy, yellow discharge from 
the genital tract. Ulceration of the genital 
tract. 

Hydrastis is a drug for chronic nose and 
throat trouble, chronic gastric catarrh and 
chronic catarrh of the bowels ; also, of the 
genito -urinary tract. Remember, that the dis- 
charge of Hydrastis is yellow, thick and tena- 
cious. 

HAMAMELIS. 

Dose. — Ten to 30 drops of the fluid extract 
three or four times a day. 

Hamamelis is a good remedy for blood 
spitting in 5 to 10 drops every two or three 
hours until better. 

Itching or painful piles are much relieved 
by bathing them in a warm solution of Hama- 
melis and hot water of equal parts. 

For diseases of the vagina, with a white, 
milky discharge and a heavy, sore feeling of 
the womb and pain in the back, Hamamelis 1 
ounce to the pint of hot water makes a very 
soothing and healing injection. 

Hamamelis is a very soothing application 
when rubbed on bruised or injured surfaces 
or used as wet dressing to injured parts. 
Hamamelis acts much the same as Arnica, 
and is safer where the skin has been broken, 
for Arnica has been known to set up erysipelas 
when applied to areas where the skin has been 
broken. 



214 MEDICAL HANDBOOK. 

HYOSCYAMUS NIGER (HOMCEOPATHIC) . 

Dose. — 6 to 6x, i to 3 tablets every three or 
four hours. 

Indications for Hyoscyamus. — Muttering 
delirium, with pricking at the bed clothing; 
does not recognize friends, fear of being 
poisoned, may become furious and use inde- 
cent language and be immodest; there is spark- 
ling eyes, red face and congestion of the brain ; 
objects appear red or double, blinking of the 
eyelids, tongue dry and clean, yet the patient 
may foam at the mouth and swallow with 
difficulty; there is thirst, but the patient 
dreads to drink and drinks very little at a 
time with apparent difficulty ; there may be in- 
voluntary movements of the bowels of a yel- 
low, watery nature ; the urine may pass with- 
out the knowledge of the patient or be very 
scarce and at times suppressed ; there may be 
spasms during sleep, dry, spasmodic cough, 
relieved by sitting up ; slow breathing, with 
rattling in the chest; in fevers the pulse is 
hard and full ; congestion of the brain, with 
hot head and face, though the hands and feet 
may be cold; hot all over the body in the 
evening, perspires during the sleep and feels 
weaker after perspiring, desires to be uncov- 
ered or to be naked. 

Hyoscyamus is often indicated during the 
delirious stage of typhoid fever and for de- 



LOCAL USE OF COLD AND HEAT. 215 

rangement of the mind, with hallucinations 
and imaginings and glassy eye, jealousy and 
talkative and silly, goes rapidly from one sub- 
ject to another, is obscene of speech and im- 
modest in actions ; insanity, delirium and 
jealousy often call for Hyoscyamus. , 

LOCAL USE OF COLD AND HEAT. 

Poultices applied to inflamed and painfui 
parts afford much comfort and often hasten 
restoration. Flax seed, oat meal or bran 
may be used. Stir whichever ingredient is to 
be used into boiling water until a thick pap 
is formed, spread on muslin and smear the 
surface with lard or sweet oil, cover the out- 
side with oiled paper and several folds of 
flannel to retain the heat and moisture. Oiled 
silk or oil-cloth may be used instead of paper 
if handy. Poultices should be applied hot and 
changed frequently. Several folds of cloth 
wrung out of hot water and applied hot can be 
used much the same as poultices. Often drugs 
are added to the water, making the applica- 
tion of hot fomentations of double value. Cold 
applications are used in the early stage of 
bruises and strains. Several folds of cloth 
are rung out of ice water and applied in the 
same manner as hot fomentations, only there 
should be no covering to retain heat. Hot 
pads of salt or sand are often used where dry 
heat is wished to a painful part. The hot 



2l6 MEDICAI, HANDBOOK. 

water bottle or bag is the most frequent ap- 
plication to supply heat to the surface. As 
a rule these bottles are of rubber, but com- 
mon bottles may be used in their absence. 
Care should be observed not to burn the pa- 
tient. Those coming out of ether have fre- 
quently been burned by careless nurses. Cover 
the hot water bottle with some woolen cloth 
and keep to the desired heat by changing the 
water. A quite cold, or quite hot, fomentation 
applied to the chest on retiring will often stop 
an irritating cough that prevents sleep. 

IODOFORM UM IODOFORM. 

Iodoform is in small, lemon yellow crystals 
and has a very tenacious and insuppressible 
odor. Iodoform has been used as a drug, but its 
chief field of action is as a local dressing for 
wounds. Applied to wounds or sores the ef- 
fect is to ease the pain, cleanse the wound by 
the liberation of its Iodine under the influ- 
ence of heat and moisture of the body and 
to stimulate the injured tissues, thus hasten- 
ing healing. Continued for a long time or 
used in large quantities over extended areas 
there is danger of poisoning from the drug. 

The symptoms of Iodoform poisoning which 
require its immediate cessation are headache, 
loss of appetite, rapid pulse, depression, 
drowsiness and faintness or marked restless- 
ness. There is delirium in the later stages 



REMEDIES. 217 

of poisoning from this drug. The tempera- 
ture is not much raised by this drug. On 
small wounds the pure drug may be used, 
but on large injuries it is best used one part 
of Iodoform with two parts of Boracic Acid. 

IODUM. IODINE. 

This drug should be preserved in glass- 
stoppered bottles in a cool place. On remov- 
ing the cork Iodine gives off a purple vapor. 

Tincture Iodine painted on sprains and sub- 
cutaneous swellings is of much service as a 
counter-irritant. Enlarged, inflamed and 
hardened glands are often reduced and soft- 
ened by the local use of this drug. In a region 
affected by erysipelas iodine is often of much 
value when painted around the inflamed area 
that the infection does not spread to healthy 
parts of the body. 

The benign action of Iodide of Potassium 
on enlarged glands, when taken internally, is 
due to the Iodine. 

Iodoform owes its kind action over wound- 
ed areas to the fact that the Iodine is liberated 
from the Iodoform by the action of heat and 
moisture in the wounded area. 

Constitutional symptoms are sometimes pro- 
duced by the use of Iodoform on wounds and 
by the use of the Iodides internally. A mild 
iodism is often produced, having some or all 
of the following symptoms : Pain over the 



2l8 MEDICAL HANDBOOK. 

eyes, soreness and heaviness of the mouth and 
throat an excess of spittle and perhaps an 
eruption over the body. If these symptoms 
become worse and others develop, the drug 
should be discontinued or much reduced in 
dose. 

IPECACUANHA. 

Dose. — Fluid Extract of Ipecacuanha, 2 to 5 
drops. 

Syrup of Ipecac, 5 drops to 1 teaspoonful. 

Wine of Ipecac, 5 drops to 1 teaspoonful. 

To cause vomiting, ^ to 4 teaspoonfuls of 
the Wine or Syrup ; repeat in fifteen minutes 
if necessary. , 

In the larger doses Ipecac is given as an 
emetic to produce vomiting, and is a safe and 
reliable remedy. 

From 3 to 5 drop doses of the Wine or 
Syrup of Ipecac will at times relieve an irri- 
tated stomach when there is a tendency to 
vomit. Also 3 to 5 drop doses will often be of 
much service for summer diarrhoea. Give for 
nausea or diarrhoea a small dose, and repeat 
every fifteen minutes to a half hour. 

Where there is a dry hacking cough that 
ought, to be loosened up give from 5 to 15 
drops of the Syrup of Ipecac every 3 hours. 
Ipecac in mild doses increases the action of 
the skin, and is, therefore, all the more of 
value in the treatment of colds. 



REMEDIES. 219 

For croup in children, 10 to 15 drops of the 
Wine or Syrup of Ipecac, repeated every 15 
minutes until nausea or vomiting is produced, 
is a very efficacious remedy. 

IPECACUANHA (HOMCEOPATHIC) . 

Dose. — to 3X, 1 to 5 tablets every 15 min- 
utes to every 3 hours. 

Indications for Ipecac. — Headache, bruis- 
ed feeling of the head, worse on one side. 
Pale face with blue rings around the eyes and 
mouth. Flat taste in the mouth with nausea 
and fulness of the throat. There is a con- 
tinual aversion to food with a feeling as if the 
patient would vomit. Pain in the stomach 
with nausea, worse on motion. Diarrhoea of 
green, fermented, slimy stool, with cutting and 
burning in the lower bowel and rectum at the 
time of stool. 

Dark urine which leaves a brick-dust sedi- 
ment. Rattling of the chest on breathing, 
and the chest seems full of phlegm. Difficult 
cough with little expectoration, and cough 
causes nausea. The throat seems too small 
for the air and phlegm to get through, and 
there is a blueness of the face during cough- 
ing. 

The menses are too frequent, too early, too 
profuse, and are of a bright red blood. 

Remember Ipecac for croup of children, 
cough with difficult breathing and little ex- 



220 MEDICAI, HANDBOOK. 

pectoration. Ipecac is of service in all de- 
rangements of the mucous surfaces of the 
body associated with nausea. 

For cough, give 6 or ix, i tablet every 2 
hours. For croup, give of 6 2 tablets every 
15 minutes, until better. 

For diarrhcea or nausea give or ix, 1 
tablet every two hours. 

IGNATIA AMARA (HOMCEOPATHIC). 

Dose. — to 6x, 1 tablet three times a day. 

Indications for Ignatia. — Depression of 
mind, easily angered. Sensation as if a nail 
were driven in the side of the head. Aver- 
sion to light. Toothache as if the tooth were 
crushed. Stitches in the throat and a feeling 
as if there were a lump in the throat. No 
taste to the food. Empty feeling in the 
stomach. Pricking, stinging pain in the 
stomach as if from pins. Difficult stool as if 
the anus were too small, with sticking pain in 
the anus after a movement. Protrusion of 
piles with sticking pain. Cough with stitch- 
like pain in the chest. Palpitation of the heart 
with sticking pain in the heart. 

The menses in women are delayed, scant, 
dark in color and of an offensive odor. Cramp- 
like pains in the uterus at the time of the 
menses, and at the same time there is in- 
digestion with cramp-like pain in the stomach. 
Weakness and languor as if the woman could 



REMEDIES. 221 

not go around, and yet she refuses to give up 
and rest. 

Ignatia is a good remedy for women who 
are dark of complexion, and who do not give 
up and cry as do the Pulsatilla patients ; but 
who are, as it were, angered by their symp- 
toms and who refuse to yield to them. Re- 
member the sticking or stitch-like pains of 
Isrnatia, 



■& j 



KALI BICHROMICUM (HOMCEOPATHIC) . 

Dose.— -2x to 6x, i tablet three times a day. 

Indications for Kali Bichromicum. — Ver- 
tigo, dull, throbbing frontal headache. Heavi- 
ness of the eyes on waking in the morning. 
Swelling of the eyelids. Dryness and ulcera- 
tion of the nose with the formation of crusts. 
Greenish-yellow, offensive discharge from the 
nose. Tough, yellow, stringy discharge into 
the throat from the posterior nares. Thick, 
yellow coating of the tongue. Inflamed ton- 
sils that are covered with a stringy mucus 
that is hard to dislodge. Hoarseness of the 
voice in the evening. Tickling of the throat. 
Cough with difficult expectoration. Pain back 
of the breast bone extending between the 
shoulders. Desire for acids and sour foods. 
Indigestion. After eating, fullness and dis- 
tension of the abdomen. Cutting pain in the 
abdomen and stitch-like pain in the region of 
the liver. Constipation. Movements are dry 



222 MEDICAL HANDBOOK 

and lumpy, and are followed by burning in 

the anus. 

In women there is a yellow, stringy leucor- 
rhcea that scalds and burns the parts. Sore- 
ness of the genital tract. 

Remember Kali bich. when there is a tena- 
acious, stringy discharge from any of the 
mucous surfaces. 

Fat, fair children often have symptoms call- 
ing for this drug. 

KALI CARBONICUM (HOMOEOPATHIC) . 

Dose. — 2x to 6x, i tablet three times a day. 

Indications for Kali carb. — Headache 
when on the cars. Headache on one side of 
head. Tendency to take cold in the head. 
Redness of the eyes. Sticking of the eyelids 
together in the morning. Spots before the 
eyes. Swelling of the upper eyelids. Crack- 
ing sound in the ears. Ulcer of nose. Desire 
for sour foods. Constipation with colicky 
pain before stools. Large movements passed 
with white mucus. Burning in the anus after 
stool. Hoarseness of the voice. Dry, hard 
cough. Stitches in the right side of the chest, 
in the heart, in the liver and in the kidneys 
and back. Swelling of the glands of the 
neck. Pain in the limbs. Rheumatic pains 
extending down the arms and legs. The sex- 
ual desire is weak. The menses too late, too 
scant and too light in color. Leucorrhcea with 
pain in the back. 



REMEDIES. 223 

LYCOPODIUM (HOMCEOPATHIC). 

Dose. — 2x to 6x, 1 tablet three times a day. 

Headache worse from stooping or lying 
down. Pain in the temples as if the sides of 
the head were pressed in a vise. Indifference 
of the mind with a tendency to cry. Wants 
company, cannot bear to be alone. Sleepy in 
the day, and cannot sleep at night. Roaring 
in the ears. Sallow color with dark rings 
around the eyes. Sense of smell very acute. 
Difficult breathing with motion of the angles 
of the nose during the act of breathing. 
Toothache, dry tongue. Sore throat with 
spots or ulcers on the tonsils. Intense hunger, 
but there is a bloated sensation as soon as a 
little food is eaten. Windy rumbling of the 
bowels. Constipation, and when the bowels 
do move there is still a feeling as if the bowel 
was not empty. The urine is scant and soon 
deposits a yellow, sandy sediment. Before 
voiding urine there is intense pain in the 
bladder. Cough worse in the evening, asso- 
ciated with stitch-like pain in the left side of 
the chest. Salty tasting, thick, yellow ex- 
pectoration from the chest and nose. 

Stiffness of the neck with swelling of the 
glands. Pain in the small of the back. Itch- 
ing of the skin. Dry, harsh, cracked skin. 
Redness and swelling of the joints. Pain in 
the hip-joint. Ulcers on the limbs that itch 
and burn at night. 



224 MEDICAL HANDBOOK. 

LACHESIS (HOMOEOPATHIC). 

Dose. — 6x. i tablet three times a day. 

Indications for Lachesis— Giddiness and 
heaviness of the head. Headache with nausea 
and chilliness. Tendency to be sad with in- 
disposition to think. Burning in the mouth 
with dry, trembling tongue. Pain in the left 
side of the throat. Sensitiveness of the 
throat, cannot bear to have the collar touch 
the throat. Bitter taste to everything that is 
eaten. Food comes back into the throat after 
being swallowed. Burning and griping in the 
abdomen. Alternating constipation and diar- 
rhoea. The urine is dark or yellow, and there 
is a sensation as if a lump were in the bladder. 
The left ovary is swollen, with sharp, stitch- 
ing pains. Cough with pain in the left side 
of the chest. Cough worse in the morning. 
Neck very sensitive, and slight pressure on 
the throat causes severe coughing. Ulcers of 
the skin that are tender and burn after being 
dressed. Offensive discharge from very sen- 
sitive ulcers. 

The Lachesis patient is of depressed spirits. 
Always worse after sleep. The surface of the 
body is tender to touch. The left side of the 
body is more affected than the right. 

MERCURIUS CORROSIVUS (HOMOEOPATHIC) . 

Dose. — 3x to 6x, i tablet three times a day. 



REMEDIES. 225 

Indications for Mercury. — Anxiety, sleep- 
less. Vacant, stares at persons and does not 
understand. Dizziness. Sore eyes with edges 
crusted. Sore nose with dry scabbing. Burn- 
ing in the mouth and stomach. Sore throat. 
Ulcerated tonsils. Diarrhoea with cutting, 
colicky pains. Dark urine that leaves a 
brick-red sediment. 

CORROSIVE SUBLIMATE ( ALLOPATHIC ) . 

The Bichloride of Mercury is used as an 
antisyphilitic in doses of 1 / 100 part of a grain, 
three times a day. 

The Blue Ointment of Mercury is also used 
as an antisyphilitic, and to reduce swollen 
glands. Used by rubbing in well once or 
twice a day. 

Corrosive Sublimate is also used as an anti- 
septic, but in the quantity needed as an anti- 
septic it is a violent poison. 

NUX VOMICA. 

Dose. — Tr. Nux vomica, 1 to 10 drops, 
three times a day. 

Strychnine Sulphate, 1 / 100 part of a grain, 
three times a day. 

Nux vomica stimulates the heart and nerve 
centres. The spinal cord in particular. In- 
creases and strengthens the pulse. Quickens 
and deepens the breathing. Increases the ac- 
tion of the stomach and bowels. Nux vomica 

15 



226 MEDICAL HANDBOOK. 

exerts a tonic effect on the heart, lungs, di- 
gestion and nervous system. 

For heart failure from accident or injury 10 
drops of the Tincture of Nux vomica, or * / 
part of a grain of Strychnine sulph., will 
strengthen the heart's action. 

For numbness and paralytic affections fol- 
lowing diphtheria, scarlet fever and allied 
affections, Nux vomica has a strong restora- 
tive action on the nerves. Give 3 drops of the 
Tr. Nux vom. three times a day, and if neces- 
sary, inject a small amount into the paralyzed 
area, using the Strychnine sulph., and giving 
the same with a hypodermic syringe. For 
chronic constipation or those suffering from 
a relaxed condition of the abdomen. The 
aged or fat, flabby people, give Tr. Nux vom., 
3 drops, three times a day. 

For chronic dyspepsia, 2 to 4 drops of the 
Tr. Nux vom. before meals will aid digestion 
very much. After dinner if there is indiges- 
tion, the same dose will help to stimulate the 
stomach to get rid of its burden. 

If, after giving Nux vom. for some time, 
there is twitching of the limbs, acute vision, 
restlessness and a stiff neck, you may know 
there has been enough of the drug given, and 
it should at once be discontinued. 

NUX VOMICA (HOMOEOPATHIC). 

Dose. — to 6x, 1 to 4 tablets three times a 
day. 



REMEDIES. 227 

Indications for Nux vomica. — Irritable, 
easily angered. Noise, light and strong odors 
are unbearable. Wishes to be alone. Mental 
derangement with a desire to kill. Delirium 
from alcoholic drinks. Pain on top of the 
head as if a nail were driven in. Head feels 
too large. Dizziness and ringing in the ears. 
Bloodshot eyes or bloody spots in the mem- 
branes of the eye. Running of the nose in the 
day and dryness of the nose at night. Sal- 
low, pale complexion. Can't sleep after 3 a. 
m. Sore spots in the mouth. Sore throat. 
Rawness of the throat on swallowing. 
Tongue coated black. Bitter taste in the 
mouth and offensive breath. Sour belching. 
Stomach painful to pressure. Clothing feels 
too tight. Fullness after eating, with feeling 
of pressure on the stomach. Cramp-like pain 
in the stomach and abdomen. Constipation 
with difficult passage of stool. Pain in the 
rectum with a tendency to haemorrhoids. 
Difficult urination of a small amount of 
bloody urine. Dry cough, worse in the early 
morning, worse from eating and worse from 
lying on the back. Chest feels as if being 
pressed upon by a heavy load. Pain in the 
neck, between shoulders and back of the 
shoulder-blades. Pain in the back. Numb- 
ness of the limbs. 

In men pinching, constrictive pain in the 
testicle. Pain in the back from weakness and 



228 MKDICAI, HANDBOOK. 

nervousness from over sexual indulgence or 
from nocturnal emissions. In women the 
menses are too early, too excessive, and of 
dark or black blood. Irregular menstruation. 
Vomiting of pregnancy. Threatened miscar- 
riage with a desire to urinate and move the 
bowels at frequent intervals. 

Remember Nux vomica for dark complected 
persons who cannot sleep. For irritableness 
and indigestion, and for the bad effects of 
over-indulgence in any way. 

OPIUM. 

Opium is the gum from the Papaver som- 
niferum, a plant of Asia. The extended use 
of the drug in medicine in many forms, and 
in its various alkaloids, also its combination 
with other drugs, makes it a very valuable 
drug and one worthy of careful consideration. 

The great tendency to form the drug habit 
makes it a drug to be feared, and used with 
great caution by physician and patient. 

The many fatal results from its use should 
make all think twice before prescribing it. 

Opium, Morphine and Tr. Opii or Laud- 
anum are all one in their results so far as 
the danger from the use of the drug goes. 
There are many alkaloids of Opium, but for 
this present subject in hand they will not be 
mentioned. Children and the aged are very 
susceptible to Opium in any and all of its 



REMEDIES. 229 

forms and preparations, and its use for such 
persons should be very urgent before the 
drug is employed, as small doses have proven 
fatal when none suspected that there was any 
danger. 

Dover's Powders, Brown mixture, and the 
various cough compounds have Opium as one 
of the most active ingredients. 

Morphine is the active principle or alkaloid 
of Opium, and has much the same action as 
the crude drug. 

Laudanum or Tr. Opii retains all of the 
active principles of Opium, and should be 
used as nothing more or less than Opium. 

In medical doses the effect of Opium is first 
to produce a short period of exhilaration or 
excitement followed by drowsiness, and an 
almost irresistible desire to sleep. The sleep, 
however, is not natural, as the drug con- 
tinues its exciting influence on the brain ; 
dreams chase each other through the mind, or 
a gentle revery seizes the sleeper and the 
mind follows up the phantom dream, forget- 
ting all else. An itching or tingling of the 
skin is one of the first* symptoms that the drug 
is beginning to act. 

In overdoses the sleep is profound, follow- 
ing very soon upon the first stage of excite- 
ment. Snoring or stertorous breathing is 
marked, and the pulse, though weakened, is 
full and slow. There is almost total insen- 



230 MEDICAL HANDBOOK. 

sibility to external impressions. In the latter 
stages of poisoning the pallid countenance is 
very marked and the face is bathed in a 
clammy sweat. 

Where an overdose of the drug has been in- 
jected from whatever cause the first thing to 
be done is to empty the stomach by an emetic 
of mustard and Ipecac, or by the use of Ipecac 
alone, or by any other good and prompt 
emetic. Strong black coffee should be given 
internally, and the patient kept from going to 
sleep by being walked about, and also by 
striking him with a wet towel, or, in fact, 
any device to prevent sleep. To stimulate the 
lungs and the breathing, Atropine Sulphate 
should be given hypodermically, 1 / 50 th part 
of a grain. Where there has been much of the 
Opium taken there will be need of more than 
3 7 / 5o § ram °^ tne Atropine. Hypodermic in- 
jections of the 1 per cent, solution of the Per- 
manganate of Potash is also of service. 

Opium is contra-indicated in all diseases of 
the brain, and in any affection where there is 
much mental excitement. See Bromide of 
Potash for such cases. 

The full medical dose of Opium is 1 grain, 
of Morphine Sulphate ^4 grain, and of Laud- 
anum 11 minims, or 22 drops. Try a smaller 
dose before using the full medical dose. 
Opium dries up the mucous secretions of the 
body and constipates the bowels. Babes have 



REMEDIES. 231 

been fatally affected by giving a nursing 
mother the full medical dose of the drug. 
Beware of the drug where there are children. 

POTASS II BROMIDE, BROMIDE OF POTASH. 

Bromide of Potash is in colorless crystals, 
odorless and is salty of taste and is perma- 
nent in dry air. 

The medical uses of the drug are to pro- 
duce a quieting influence on the nervous sys- 
tem. It is of much value in the convulsions of 
children. Puerperal convulsions and general 
nervous excitement and unrest. The dose is 
from 20 to 60 grains for adults and 3 to 8 
grains for children. In cases of convulsions 
the dose may be given every twenty minutes 
for 2 or 3 doses, and also it may be neces- 
sary to increase the dose a half or even give 
double the amount indicated. 

Do not use the drug continually for weeks 
or months, as the drug habit may be formed. 

POTASSII IODIUM, IODIDE OF POTASSIUM. 

Iodide of Potassium is in colorless trans- 
lucent crystals, having a faint odor, pungent, 
salty taste that afterwards is bitter. 

The drug is of especial value in syphilis 
and tubercular affections, glandular en- 
largements and as a tonic. Dose, from 3 to 10 
grains three times a day well diluted in water. 



232 MEDICAL HANDBOOK. 

POTASSII CHLORAS, POTASSIUM CHLORATE. 

Chlorate of Potassium is a colorless, pearly 
powder, odorless and salty of taste. The drug 
is chiefly used for sore mouth and sore throat. 
Tablets of from 3 to 5 grains may be held in 
the mouth and allowed to dissolve, thus bath- 
ing the sore or sores in the solution, after 
which it may be expectorated or swallowed at 
will. The continued use of the drug has a 
bad result on the kidneys and it should not 
be used over an extended period. 

POTASSI PERMANGANAS, PERMANGANATE OF 
POTASH. 

Potassium Permanganate comes in deep 
purple crystals, having no odor. Is very solu- 
ble in water. The value of this drug is prin- 
cipally due to the amount of oxygen it carries. 
The drug is used as a disinfectant and deodor- 
izer. Applied in a strength of 10 to 20 per 
cent, solution it disinfects, deodorizes and 
stimulates old or slow healing ulcers. In 
strong solution it acts as a caustic. Internally 
it has been used for the poisoning of Opium 
or Laudanum. It is best used for this pur- 
pose in the 1 per cent, solution hypodermical- 
ly. The medical dose of the drug is from 1 
to 2 grains. Alcohol decomposes the drug and 
should not be used in conjunction with Potas- 
sium Permanganate. 



REMEDIES. 233 

PHOSPHORIC ACID (HOMCEOPATHIC) . 

Dose. — 3X to 6x, 1 tablet three or four times 
a day. 

Indicated for Phosphoric Acid. — Head- 
ache, worse from motion or noise ; pain in the 
top of the head, low spirits, with no desire to 
talk; ringing in the ears, annoyed by a noise 
or conversation, stye on the eyelids, cold feel- 
ing of the eyes, dark-coated, dry tongue, with 
sticky mucus in the mouth ; pain in the front 
teeth, bitter taste in the mouth, the stomach 
feels as if suspended, desire for juicy fruits 
or foods, cramp of the abdomen, watery diar- 
rhoea, milky urine, pain in the back, soreness 
and weakness of the throat, hoarseness and 
tickling in the throat, causing cough ; rash 
of the whole skin of the body, resembling 
scarlet fever. 

Weakness and relaxation of the sexual 
organs, dragging, gnawing pain in the tes- 
ticles, nocturnal emissions, weakness in the 
back and legs, itching and burning in the end 
of the penis. 

Phosphoric acid is to be thought of in the 
nervous exhausted condition of homesick- 
ness, of over-nervous strain, for grief and 
anxiety and all debility with low spirits. 

PHOSPHORUS (HOMOEOPATHIC). 

Dose. — 4X to 6x, tablet every three to six 
hours. 



234 MEDICAI, HANDBOOK. 

Indications for Phosphorus.* — Dizziness 
on rising, dull headache, worse in the morn- 
ing on rising from bed; wakefulness or very 
light sleep, but sleepy after meals ; fearful of 
something in the distant parts of the room, 
noise in the ears, burning in the eyes, black 
spots before the eyes, halo around the lamp at 
night, nosebleed on slight provocation, dryness 
of the mouth and throat, tongue coated white, 
thirst for cold drinks, vomits when the con- 
tents of the stomach becomes warm, pain in 
the stomach, emptiness of the stomach, sour 
belching, waxy stools that are long and very 
difficult to pass, dark urine that leaves a brick 
dust sediment, pain in the back, dry, tight 
cough, hoarseness of the voice, stitches in the 
chest, rusty or frothy blood-colored sputa, 
cough excited by cold air or the use of the 
voice. Phosphorus is good in lower fevers, 
with involvement of the chest, night sweats, 
blue lips and open mouth and burning and 
itching of the skin of the whole body. 

In the male there is irresistible desire for 
sexual satisfaction, but sexual power is want- 
ing and the act may be a failure. Dreams, 
with emissions. In the female there is nose- 
bleed instead of the menses at the time of the 
flow. 

Remember Phosphorus for tall, dark com- 
plected persons and for men in particular. 



REMEDIES. 235 



PLUMBI ACITAS,, SUGAR OF LEAD. 

Sugar of lead is in colorless, transparent 
crystals, has a faint acid odor and a sweetish 
astringent taste. Should be kept in well-stop- 
pered bottles, as it is acted upon by the air. 
Sugar of lead is soluble in water. In large 
doses internally the drug is an irritant poison. 

Lead Water and Laudanum is one of the 
most useful preparations made from this drug. 

Dressings saturated with Lead Water and 
Laudanum and applied to bruises where the 
skin is not broken, sprains and subcutaneous 
injuries are soothing to the pain and material- 
ly lessen the swelling. 

The Lotion of Lead Water and Laudanum 
is made as follows : 

]J. Sugar of Lead, 120 grains. Laudanum 
or Tr. Opii, V 2 fluid ounce. Water, 16 fluid- 
ounces. 

Dissolve the Sugar of Lead in 10 ounces of 
hot water, and then add the Laudanum and 
enough water to make 16 fluidounces. 

Shake well before using. 

PULSATILLA NIGRICANS ( HOMOEOPATHIC) . 

Dose.--0 to 3x, from 3 to 5 tablets every 
three to six hours. 

Indications for Pulsatilla. — A weeping 
disposition, dizziness on rising, head feels 
empty, one-sided headache that is worse in the 



236 M3DICAI, HANDBOOK. 

evening and worse from lying down, better 
from sitting up and better from being in the 
open air, hardness of hearing, purulent dis- 
charge from the ears, the margins of the eye- 
lids are sore, with a tendency to styes ; green, 
offensive discharge from the nose, yellow or 
sallow complexion, with dark rings around the 
eyes ; tongue coated yellow, sore throat, tooth- 
ache, offensive taste in the mouth, with 
nausea; colic and rumbling in the abdomen, 
followed by diarrhoea ; worse at night, fre- 
quent urination of clear urine, inability to hold 
the urine, dry cough when lying down, better 
from sitting up, hoarseness, stitches in the 
chest and in the region of the heart, tight- 
ness of the chest, sleepy in the day, but can- 
not sleep at night from the rapid change of 
ideas, restless, wakeful, frightful dreams. 

In women the menses are too scant, ap- 
pear too late and are associated with abdom- 
inal pain, bland, watery discharge instead of 
the flow, stoppage of the flow from exposure, 
nervous symptoms, but no flow in girls who 
should begin to menstruate, colic when the 
flow does come, so that the patient tosses 
about and may cry from the pain. 

In men there is pain in the rectum and 
bladder, with a clear discharge ; soreness and 
a sickening pain in the testicle. Pulsatilla is 
the remedy for light complected women who 
are sad, who flow late or the flow is scant, 



REMKDIKS. 237 

who have dark rings under the eyes and who 
are tender in the abdomen at time of the 
flow. Pulsatilla is indicated for bland dis- 
charges from the eyes, ears, nose and geni- 
tal tract and stoppage of the flow from ex- 
posure. 

PHYTOLACCA DECANDRA (HOMOZOPATHIC) . 

Dose. — to 3x, 2 to 4 tablets three times a 
day. 

Indications for Phytolacca. — Indifference 
of mind, with sick headache; backache and 
general exhausted feeling, watery discharge 
from the nose, one side of the nose clogged 
and the other open, sore throat that is dark 
red, excessive saliva in the mouth, swelling of 
the glands of the neck, goitre, bruised sore- 
ness of the stomach, with belching and vomit- 
ing of food, of bile or of slimy mucus, thin, 
dark stools ; there is a bruised feeling of the 
muscles, worse in the house, worse at night 
and worse in damp weather, better from mo- 
tion and from being in the open air. 

In the female breast lumps or hard nodules, 
pain extending over the breast on nursing. 

Phytolacca is to be thought of for females 
who have a tendency to get fat and who are 
subject to glandular enlargements, especially 
of the neck and of the breast. 



238 MEDICAL HANDBOOK. 

QUININE SULPHATE. 

Dose. — From 1 to 20 grains ; usual dose, ;< 
to 10 grains. 

Quinine in large doses or in small oft repeat- 
ed doses causes a fullness of the head, with 
ringing in the ears and deafness or poor hear- 
ing. Quinine congests the head and middle 
ear and would be contraindicated in any af- 
fection where there is an excess of blood to 
the head or ear. Small doses of Quinine stim- 
ulate the digestion, and what is not absorbed 
in the stomach passes on into the intestines 
and acts as an antiseptic there. For the anti- 
septic action in the intestines Quinine is much 
prescribed in typ'hoid fever. For diarrhoea of 
the amoebic variety, or army diarrhoea or 
bloody flux, much benefit may be derived from 
washing out the lower bowel with a solution 
of from 7 to 15 grains to the pint of boiled 
water. Quinine is often given in 2 or 3 grain 
doses after meals as a general tonic for a run 
down condition of the system. Quinine has an 
action in the blood to destroy the germs of 
malaria. Ten grain doses for two or three 
doses an hour apart before the time of the 
expected chill in malaria will often avert the 
chill. In the course of one morning in malaria 
it is best not to exceed 20 or 25 grains of 
Quinine as the aggregate amount of the drug 
given. 



REMEDIES. 239 

In the early stage of labor, when the pains 
are irregular and weak, 10 grains of Quinine 
and ' three or four teaspoonfuls of whisky 
will often hasten regular and firm labor pains. 

Some people cannot take Quinine, and even 
small doses will produce a red rash of the 
skin, much resembling scarlet fever or of 
hives or of ivy poison. To such persons 
Quinine should not be given. 

TINCTURE OF STROPHANTHUS. 

Dose. — Tr. Strophanthus, 1 to 3 drops 
morning and evening. 

Strophanthus has not the culminative action 
of Digitalis, does not act on the nerves of the 
heart and arteries as does Digitalis. Strophan- 
thus acts directly on the heart muscle itself 
and the muscular walls of the blood vessels. 
For this reason Strophanthus is a prime rem- 
edy where there is failing of the heart or 
arteries. Digitalis again is best where there 
is a disturbance of function and little real 
impairment of the heart or blood vessels them- 
selves. Strophanthus slows the heart and in- 
creases the force of the heart's action, in- 
creases the flow of urine by direct stimulation 
of the circulation in the kidney. 

The indications calling for the drug are a 
weak heart, scant urination, blue lips, dizzi- 
ness or faintness associated with palpitation 
and shortness of breath on exertion. 



240 MEDICAL HANDBOOK. 



EPSOM SALTS. 



Dose. — i to 8 teaspoonfuls, given well di- 
luted in water. 

Epsom Salts causes the intestinal mucous 
membrane to give off a great amount of fluid, 
prevents the absorption of the fluid from the 
food and causes a movement in much the same 
manner as an enema. The distension of the 
intestine with fluid encourages the action of 
the muscles of the intestines and a movement 
is produced. Where there is constipation and 
an accumulation of hardened faeces in the in- 
testines Epsom Salts should be given first 
choice, as it increases the fluid of the bowel 
and assists thus in getting rid of any hardened 
masses. 

In chronic lead poisoning Epsom Salts re- 
lieves the constipation and combines with the 
lead to form a non-poisonous compound. In 
Carbolic Acid poisoning Epsom Salts acts 
much the same as in lead poison, by moving 
the bowels and combining with the acid to 
form a non-poisonous substance. In poison 
cases, after the bowels have been moved, give 
salts in small doses three or four times a day. 

To produce catharsis dissolve the salts in 
a half glass of water and drink at one draught, 
best before breakfast. If nausea is produced, 
add 3 grains of the Carbonate of Magnesia 
to each drachm of salts used. Epsom Salts is 



RKMKDIKS. 241 

not a good remedy for the atony of the bowel 
and constipation of elderly people. 

SUPPOSITORIES. 

Suppositories produce much the same result 
and are given for the same purposes as 
enemata. Suppositories may be medicated or 
non-medicated. They are usually oblong and 
made of some substance that, though firm 
enough to handle, readily melts from the heat 
of the body. By their action they stimulate 
the bowels to move. If medicated they are 
used as a vehicle to carry the medicine to the 
part. Cacao butter is the chief ingredient of 
laxative suppositories ; pure and of itself it 
acts much the same as an enemata of watei, 
moving the bowels in about 15 minutes to a 
half hour. Glycerine suppositories are much 
used to cause evacuation of the bowels. Small 
suppositories are very useful to cause move- 
ment in infants and small children. Medicated 
suppositories are given according to the direc- 
tions of a physician. To give a suppository 
have the patient, as in enemata, lie down 
on the left side, and as the nozzel of the syringe 
should be introduced, so also should the sup- 
pository, upward, backward and slightly to the 
left. Never use any force. 

SODII SALICYLIC, SALICYLATE OF SODIUM. 

The pure drug is found in small, white crys- 
16 



242 mkdicai, handbook:. 

talline powder, odorless and having a sweetish, 
salty taste. The chief use of the drug is to 
alleviate the pain and inflammation of rheu- 
matism. 

One dose is 15 grains, three times a day. 

STRAMONIUM (HOMOEOPATHIC). 

Dose. — to 6x, from 2 to 3 tablets every 
three to six hours. 

Indications for Stramonium. — Delirium, 
very talkative, sees objects coming from the 
corners of the room, animals spring up be- 
fore the eyes, laughs, sings and dances, fears 
the dark, wants light and company, imagines 
all sorts of things, sparkling, staring eyes, with 
dilated pupils; imagines evil is coming to him 
or is being planned about him, grinds the 
teeth, does not want water, food tastes un- 
natural, sleepy, but cannot sleep. 

Stramonium is the prime remedy for over- 
wrought nerves, for excessive nervousness, 
with great imaginings and sleeplessness ; is 
one of the best remedies for acute mania or 
insanity. For some of the acute deliriums 
of the fevers. In mental derangement look up 
Belladonna, Hyoscyamus and Stramonium. 

SILICEA (HOMOEOPATHIC). 

Dose. — 6x to iox, 1 tablet three times a day. 
Indications for Silicea. — Great sensitive- 
ness to noise, poorly nourished, child cries if 



RKMKDIKS. 243 

spoken to, pain in the neck, extending up over 
the head to the forehead; worse on the right 
side, better from warmth, pustular eruption of 
the eyelids, with burning and smarting; mid- 
dle ear disease, ulcers in the nose, abscess at 
root of the teeth, ulcers on the tonsils, bitter 
taste in the mouth, constipation, scant urina- 
tion, with yellow sediment; pain in the joints 
of the feet, intense pain in the joints of the 
next to the little toe when wearing shoe, of- 
fensive perspiration of the feet. 

Silicea is a prime remedy for suppurating 
conditions where wounds heal poorly, derang- 
ed condition of the skin where every scratch 
develops into a sore. For nervous scrofulous 
subjects, with swelling of the glands of the 
neck, axilla, breast and groin ; for styes and 
purulent eye troubles, purulent discharges from 
the ears, ulcers of the throat that do not heal, 
felons and suppurative bone diseases. 

SULPHUR. 

Dose. — Sublimed Sulphur, 5 to 120 grains. 

Sulphur is said to purify the blood and has 
been used for this purpose for many years. 
Given in molasses, one to two teaspoonfuls 
may be given daily until the bowels move 
freely. 

For rheumatism of the joints 10 to 15 grains 
three times a day has often proven beneficial. 

Locally Sulphur is a valuable remedy for 



244 MEDICAL HANDBOOK. 

skin diseases where redness and swelling are 
absent. 

For the itch and for ringworm two tea- 
spoonfuls of Sulphur to eight teaspoonfuls of 
lard makes a very reliable remedy. Rub in 
well once a day for a week and then take 
a bath for the first time during the week of 
treatment. 

SULPHUR (HOMOEOPATHIC). 

Dose. — ix to 6x, 3 tablets three or four 
times a day. 

Indications for Sulphur. — Dizziness when 
sitting, heat on top of the head, fullness of the 
forehead, throbbing headache in the morning, 
large opening on the top of the head in babes 
that closes late, light sleep, dullness of thought, 
forgets words, inclined to be sorrowful and 
ill-natured, intolerance of light, black spots be- 
fore the eyes, eyes burn, roaring whizzing in 
the ears, nose bleed, blisters on the nose, dis- 
charge from the nose that burns and makes 
the nose raw, eruptions on the face, and in the 
hair, a dirty greasy appearance of the skin, 
putrid taste in the mouth, feeling as if there 
were a lump in the throat, sore swollen glands, 
intense hunger in the morning and at times 
must get out of bed because of the hunger, to 
satisfy the gone, empty feeling in the stomach. 

Desire for sweets, but sweets cause intense 
heartburn, soreness in the region of the liver 
and stomach. 



RKMKDIES. 245 

Diarrhoea early in the morning that compels 
the patient to get out of bed, constipation and 
diarrhoea alternate, uncertainty of the abdo- 
men and an unsatisfied feeling after a move- 
ment. Burning of the anus after a move- 
ment. Frequent urination of- offensive urine, 
burning of the urinary passage during urina- 
tion, pain and rattling in the chest, dry cough 
excited by talking, stitches in the chest. Mu- 
copurulent expectoration, dry, unhealthy skin, 
every injury becomes a sore, pimples of the 
skin, long lasting ulcers. 

Sulphur is to be thought of in dry harsh 
skin diseases, in a greasy condition of the 
face with black heads or comedones, for pim- 
ples and blotches of the face, in goneness of 
the stomach with hunger that must be satis- 
fied, in diarrhoea that gets the patient out of 
bed every morning, in glandular diseases with 
a tendency to the formation of abscesses, 
where all the discharges of the body burn and 
excoriate the surfaces over which they flow. 

SEPIA SUCCUS (HOMOEOPATHIC.) 

Dose. — 2x to 6x, from 2 to 3 tablets 3 times 
a day. 

Indications for Sepia. — Violent headache 
in the evening, dizziness when walking in the 
open air, one-sided headache with nausea and 
sadness, weakness of memory and an inability 
to think, does not care for friends or relatives, 



246 MEDICAL HANDBOOK. 

sleepy in the day and wakeful at night, black 
spots before the eyes, watery discharge from 
the ear, sore nose, dryness of the nose with ob- 
struction to breathing, yellowness of the face 
and marked yellowness of the bridge of the 
nose, toothache worse from hot or cold 
drinks or food, aversion to food and every- 
thing tastes salty, emptiness of the stomach 
and a feeling as if food must be taken to satis- 
fy the empty feeling, constipated, hard, diffi- 
cult stool, the urine is offensive and there is 
a tendency to wet the bed before the patient 
is aroused from sleep, clay-like or red sand- 
like deposit in the urinal after the urine has 
been left standing" for a while, cough in the 
morning, tickling in the throat exciting cough. 
In women, there may be the greatest variety 
of change from the time and nature of the 
flow. The flow is not normal in nature or 
time, and with this change there are many 
other nervous sensations or disturbances 
throughout the system, watery leucorrhcea, a 
sensation as if the womb would protrude and 
the patient sits with the legs crossed to over- 
come this feeling, toothache during pregnancy, 
itching of the genitals, with a milky discharge 
during pregnancy, and there is apt to be pain 
in the shoulder and joints of the arms, and 
heaviness of the limbs during pregnancy. 

Sepia is a good remedy where the flow is 
deranged in time or nature and for the many 



REMEDIES. 247 

nervous phenomena of the change of life and 
for the nervous disorders of pregnancy. 

TEREBINTHINA, OIL OF TURPENTINE. 

Dose. — Five to 20 drops on sugar. 

Internally, Turpentine causes a warmth of 
the stomach. Acts as an antiseptic in the 
stomach and bowels, and is used with Castor 
Oil for the destruction of tape-worm. Four 
teaspoonfuls to V/2 ounces of Castor Oil is 
thus employed. Turpentine increases the flow 
of urine. On the lungs Turpentine acts as a 
mild expectorant. 

Colic with distension of the stomach and 
bowels may be relieved by an injection of 6 
teaspoonfuls to a pint of soapy water. For 
painful joints, pain in the back or pain of the 
chest and colic, wring out a cloth from hot 
water and sprinkle on it a few drops of Tur- 
pentine and apply to the painful part. 

Turpentine, Water of Ammonia and Olive 
Oil in equal parts make a very good liniment. 

THUJA OCCIDENTALIS (HOMOEOPATHIC) . 

Dose. — 2x to 6x, 1 tablet three times a day. 

Indications for Thuja. — Always in a hurry, 
in moving and in every act. Feels as if his 
body was scattered about the bed, or was 
double, or made of glass. Sharp stabbing pain 
in the head. Diarrhoea. Burning and scalding 
of urinary tract as from hot water. Warts on 



248 MKDICAI, HANDBOOK. 

the genitals. Thuja is a good remedy for dry, 
fissured warts of the skin. Warts of the 
mucous membrane. Rheumatic affections of 
the joints associated with warty growths of 
the skin and mucous membranes. 

TARTARUS EMETICUS, TARTAR EMETIC (H0MCE0- 
PATHIC) . 

Dose. — 3X to 6x, from 1 to 2 tablets three 
times a day. 

Indications for Tartar emetic. — Confu- 
sion of the mind. Throbbing headache, bad 
humor. Dimness of vision. Flickering and 
streaks of light before the eyes. Running of 
the nose. Pale face. Red, streaked tongue. 
Flat taste in the mouth. Sore throat. Nausea 
or vomiting. Pain in the stomach. Diar- 
rhoea. Dark, cloudy urine. Difficult breath- 
ing. Fine rattling in the chest. Coughing 
with vomiting, but little expectoration. Erup- 
tions on the skin and mucous membranes. 

Tartar emetic is a good remedy for croup. 
For rattling in the chest with vomiting, but 
little expectoration. For pustular skin erup- 
tions with complications of the chest. 

veratrum viride. 

Dose. — Two to 6 drops of Tr. Veratrum 
viride. Do not exceed 20 drops in a half day. 

Veratrum viride depresses the nerve cen- 
tres. Slows the pulse and lowers the blood 



VAGINAE INJECTION. 249 

pressure throughout the arteries. In child- 
bed convulsions Veratrum viride slows and 
softens the pulse, relieves the brain of conges- 
tion and quiets the irritability of the nerves. 
Give 5 drops and repeat in 15 minutes until 
the pulse becomes slower and softer. Reduce 
the pulse to about 60 per minute, but do not 
give more than is required to reduce the pulse 
thus far. 

VAGINAL INJECTION. 

Vaginal injections are, as a rule, not needed 
in health, but their utility in disease makes 
the subject of import. Douches are of use to 
restore the flow when from some cause it has 
stopped too soon, and also to carry antiseptics 
and medical agents to the female genital tract. 
A vaginal douche to be of any service must be 
given in the recumbent posture, and be given 
slowly. Injections to restore the flow should 
be hot, not less than no degrees Fahrenheit. 
Medicated and antiseptic injections are given 
in diseases of the female genital tract, and as 
a cleansing douche after confinement. The 
size and nature of such a douche will be indi- 
cated under the head of those respective con- 
ditions. To give a douche the patient should 
lie on the back, the knees flexed, and the hips 
slightly elevated; give as directed for the effect 
desired. 



INDEX. 

Abortion, 84. 

Abscess, 9. 

Acid, carbolic, 177. 

iVcid, phosphoric, 233. 

Aconitum napellus, 168. 

Actea racemosa, 191. 

Administration of drugs, 194. 

Alum, 174. 

Amenorrhcea, 101. 

Amputations, 11. 

Anaesthesia, 154. 

Anaesthesia, examination before, 157. 

Anaesthesia, local, 166. 

Anaesthesia, preparation of patient for, 156. 

Anaesthetics, 154. 

Antimonium crudum, 174. 

Antiseptics, 176. 

Apis mellifica, 170. 

Applications, 135. 

Arnica Montana, 175. 

Arsenicum album, 171, 172. 

Asafoetida, 170, 171. 

Asphyxia, 15. 

Baptisia tinctoria, 182. 
Barley soup, 203. 
Barley water, 204. 



252 MEDICAL HANDBOOK. 

Bed-wetting, 22. 

Beef tea, 206. 

Belladonna, 179, 181. 

Berberis vulgaris, 185. 

Beta naphtol bismuth, 185. 

Bismuth subnitrate, 182. 

Blood poison, 25. 

Blood spitting, 20. 

Blue vitriol, 192. 

Boils, 19. 

Breathing, normal, 22. 

Bronchitis, 28. 

Bronchitis, chronic, 30. 

Broths, 207. 

Bruises, 18. 

Bryonia alba, 184. 

Burns, 16. 

Caffeine citras, 193. 

Calcarea carbonica, 189. 

Carbolic acid, 177. 

Carbuncle, 30. 

Cascara sagrada, 188. 

Castor oil, 187. 

Catarrh of nose and throat, 135. 

Cathartics, 186. 

Cathartic vegetable pills, 187. 

Chamomilla, 190. 

Change of life, 104. 

Chicken broth, 207. 

Chilblain, 59, 63. 

Child, the, 98. 



INDEX. 253 

China, 193. 

Chloroform, 155. 

Chloroform, contra-indications for the use of, 

163. 
Chloroform, indications for the use of, 163. 
Chloroform, the administration of, 163. 
Chronic sore, throat, 137. 
Cimicifuga, 191, 192. 
Citrate of caffeine, 153. 
Coffee, 205. 
Cold, 59- 

Cold, local use of, 215. 
Cold on chest, 28. 
Cold in head, 26. 
Colic, 49. 
Colocynth, 186. 
Conjunctivitis, 156. 
Consciousness, loss of, 167. 
Constipation, 35. 
Constipation of infants, 37. 
Consumption, 146. 
Convulsions, 32. 
Copper, sulphate of, 192. 
Corrosive sublimate, 176, 225. 
Coryza, 26. 
Cough, chronic, 30. 
Cough, whooping, 148. 
Croton oil, 188. 
Croup, 37. 
Custard, egg, 206. 



254 MEJDICAI, HANDBOOK. 

Dentition, 46. 

Diarrhoea, 43. 

Digestion, disturbances of, 47. 

Digestive system, 50. 

Digitalis, 198. 

Diphtheria, 39. 

Discharges from the bowels, 45. 

Disturbances of digestion, 47. 

Dose, 7, 194. 

Dropsy, 42. 

Dulcamara, 198. 

Dysmenorrhea, 103. 

Dyspepsia, 50. 

Earache, 55. 

Eczema, 53. 

Egg-nog, 205. 

Emergencies, how to meet, 161. 

Emetics, 199. 

Enemata, 200. 

Enuresis, 22. 

Epsom salts, 240. 

Erysipelas, 52. 

Ether, 154. 

Ether, contra-indication to giving of, 157. 

Ether, how to administer, 158. 

Ether, indications for, 157. 

Eyes, 58. 

Eyes, sore, 56. 

Face, 58. 
Fainting, 67. 



INDEX. 255 



Falling, S3. 
Farina gruel, 208. 
Ferrum, 202. 
Flooding, 89. 
Flow, want of, 101. 
Food for the sick, 203. 
Fractures, 64. 
Frost-bites, 59, 60. 

Gargles, 135. 
Gelatine,. 206. 
Gelsemium semp., 209. 
Graphites, 210. 
Grippe, 79. 
Guaiacum, 210. 

Haemorrhoids, 75. 
Hamamelis, 213. 
Headache, 72. 
Heart action, normal, 68. 
Heart disease, 69. 
Heart, palpitation of, 109. 
Heat, local use of, 215. 
Hepar sulphur, 211. 
Hiccough, 48. 
Hives, 74. 

Hydrastis Can., 212. 
Hyoscyamus niger, 214. 

Ignatia amara, 220. 
Indications for drugs, 7. 



256 MEDICAI, HANDBOOK. 

Infantile scurvy, 129. 
Influenza, 79. 
Injection, vaginal, 249. 
Iodine, 217. 
Iodoform, 216. 
Ipecacuanha, 218, 219. 
Iron, 202. 
Itch, 78. 

Jaundice, 81. 

Kali bichromicum, 221. 
Kali carbonicum, 222. 

Labor, 85. 

Lachesis, 224. 

Lead, sugar of, 235. 

Local use of cold and heat, 215. 

Lycopodium, 223. 

Measles, 95. 
Menopause, 104. 
Menstruation, 100. 
Menstruation, painful, 103. 
Mercurius corrosivus, 224. 
Mercury, bichloride, 176. 
Milk, 207. 

Milk, peptonized, 204. 
Milk punch, 204. 
Miscarriage, 84. 
Morning sickness, 83. 
Mouth, sore, 98. 
Mumps, 94. 



INDEX. 257 



Neuralgia, 106. 
Normal temperature, 144. 
Nose-bleed, 108. 
Nose, catarrh of, 135. 
Nux vomica, 225, 226. 

Oatmeal gruel, 208. 
Opium, 228. 

Organic heart trouble, 69. 
Orphol, 185. 

Palpitation of heart, 109. 

Peptonized milk, 204. 

Permanganate of potash, 2^2. 

Pharyngitis, 136. 

Phosphoric acid, 233. 

Phosphorus, 233. 

Phytolacca decandra, 237. 

Piles, 75. 

Piles, internal, JJ. 

Pin worms, 151. 

Pleurisy, 114. 

Plumbi acetas, 235. 

Pneumonia, no. 

Potassi permanganate, 2^2. 

Potassium chlorate, 232. 

Potatoes, 206. 

Preface, 6. 

Pregnancy, 82. 

Pudding, 207. 

Pulsatilla nigricans, 235. 

17 



258 MKDICAI, HANDBOOK. 

Quinine sulphate, 238. 
Quinsy, 131, 132. 

Respiration, artificial, 15. 
Rheumatism, 118. 
Rice pudding, 207. 
Rice soup, 204. 
Rickets, 117. 
Ringworm, 116. 

Salicylate of sodium, 241. 
Salts, epsom, 240. 
Scabies, 78. 
Scarlet fever, 120. 
Scurvy, 127. 
Seat worms, 151. 
Sepia succus, 245. 
Silicea, 242. 
Skin, the, 130. 
Small-pox, 123. 
Sodium salicylate of, 241. 
Sore mouth, 98. 
Sore throat, 133, 136. 
Soup, 203, 204. 
Spitting blood, 20. 
Stramonium, 242. 
Strophanthus, 239. 
Sulphur, 244. 
Suppositories, 24 t. 

Tape-worms, 145. 
Tartar emetic, 248. 



INDEX. 259 



Tartarus emet., 248. 
Tea, 205. 
Teething, 46. 

Temperature, normal, 144. 
Terebinthina, 247. 
Tetter, 53. 

Throat, catarrh of, 135. 
Throat, sore, 133, 136. 
Thuja occid., 247. 
Toast, 208, 209. 
Tongue, the, 143. 
Tonsillitis, 131. 
Toothache, 143. 
Tuberculosis, 146. 
Turpentine, 247. 
IVphoid fever, 138. 

Urine, 148. 
Urticaria, 74. 

Vaginal injection, 249. 
Varioloid, 126. 
Veratrum viride, 248. 

Wetting, bed, 22. 
Whooping-cough, 148. 
Worms, pin, 151. 
Worms, seat, 151. 
Wounds, 153. 



IAPR 28 1904 



